Active NPI
Charles T Walker, DC
- Chiropractor
- Fargo, ND
National Provider Identifier
1679718571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 753
- Practice address
- 250 25TH St S
Fargo, ND 58103-6817 - Phone
- (701) 293-8882
- Fax
- (701) 293-8854
- NPI assigned
- Dec 5, 2008
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 753 | ND | Primary |
Addresses
Primary practice location
250 25TH St S
Fargo, ND 58103-6817
Mailing address
250 25TH St S
Fargo, ND 58103-6817
Phone (701) 293-8882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040923000254 | ND | Practitioner - Chiropractic | 9537066170 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 753 | ND | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228435200000",
"number": "1679718571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 25TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036817",
"telephone_number": "701-293-8882",
"fax_number": "701-293-8854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 25TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036817",
"telephone_number": "701-293-8882",
"fax_number": "701-293-8854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "CHARLES",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-05",
"last_updated": "2008-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ND",
"license": "753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.