Active NPI
John Mark Walker, PH.D.
- Psychologist
- Livermore, CO
National Provider Identifier
1669755864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1875
- Practice address
- 475 Red Nose Mesa LN
Livermore, CO 80536-8935 - Phone
- (970) 495-0920
- NPI assigned
- Sep 23, 2011
- Last updated
- Sep 23, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1875 | CO | Primary |
Addresses
Primary practice location
475 Red Nose Mesa LN
Livermore, CO 80536-8935
Mailing address
475 Red Nose Mesa LN
Livermore, CO 80536-8935
Phone (970) 495-0920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1875 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1669755864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 RED NOSE MESA LN",
"city": "LIVERMORE",
"state": "CO",
"postal_code": "805368935",
"telephone_number": "970-495-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 RED NOSE MESA LN",
"city": "LIVERMORE",
"state": "CO",
"postal_code": "805368935",
"telephone_number": "970-495-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JOHN",
"middle_name": "MARK",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-23",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "1875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.