Charles Bruce Walsh, MD

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

52627 Issued in CT

Practice address

111 Osborne St
Danbury, CT 06810

Phone

(203) 739-7131

Fax

(203) 739-1554

NPI assigned

Jul 12, 2005

Last updated

Apr 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles Bruce Walsh, M.D. LLP

  • Specialist
  • New Rochelle, NY
  • NPI 1033306121
  NPD (past)
• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  NPD (past)
• Northwest Florida Multispecialty Physicians LLC

  • Neurological Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1790912269
  NPD (past)
• Sound Shore Physician Services

  • Clinic/Center
  • New Rochelle, NY
  • NPI 1689883068
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1659379832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1887 Kingsley Ave",
            "address_2": "Suite 1900",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734416",
            "country_code": "US",
            "telephone_number": "904-272-9041",
            "fax_number": "904-272-9992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "CHARLES",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "52627",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CT",
            "license": "52627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Walker
• Joseph Patrick Wallace Jr., PHD
• Levy Wallace, MD
• Natalie Marie Wallace, LMSW,MSW,BA
• Wendy Wallach-Delucia, M.S.
• Deanna Walton, LCSW
• David Craig Waltzer, DC
• Nancy Wang-D'Amato, APRN
• Wei-Hung Wang, M.D.
• Xiaoying Mimi Wang

• Surgical Critical Care Physician in Danbury, CT
• Providers in Danbury, CT by specialty
• Surgical Critical Care Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.