Individual provider Active NPI

Terry William Walker, OD

  • Optometrist
  • Crestline, OH
National Provider Identifier
1710906219
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5249 Issued in OH
Practice address
330 N Seltzer St
Crestline, OH 44827-1403
Phone
(419) 462-4556
Fax
(419) 462-4557
NPI assigned
Jul 18, 2006
Last updated
Aug 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5249 OH Primary

Addresses

Primary practice location

330 N Seltzer St
Crestline, OH 44827-1403

Mailing address

330 N Seltzer St
Crestline, OH 44827-1403
Phone (419) 462-4556

Other identifiers 4

IdentifierTypeStateIssuer
2201823OtherOHUNITED HEALTHCARE
2263161MedicaidOH
000000241963OtherOHANTHEM
410049534OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090626000362 OH Practitioner - Optometry 8729139035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Ohio Family Care Center IncGroup PAC ID 3274437082, 194 clinicians
Galion Community HospitalGroup PAC ID 5496737439, 40 clinicians

Practice addresses (Care Compare)

2981 W 4TH St
Ontario, OH 44906-1267
Phone (419) 468-0505

330 N Seltzer St
Crestline, OH 44827-1403
Phone (419) 468-0505

385 N Seltzer St
Crestline, OH 44827-1400
Phone (419) 468-0449

700 N Columbus St
Crestline, OH 44827-1455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5249OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Galion Community Hospital CurrentSince May 21, 2010 Accepting new patients
Galion Community Hospital CurrentSince May 21, 2010 Accepting new patients

Locations

330 N Seltzer St
Crestline, OH 44827
Phone (419) 468-0796

385 N Seltzer St
Crestline, OH 44827
Phone (419) 468-0449

700 N Columbus St
Crestline, OH 44827
Phone (419) 462-3485

269 Portland Way S
Galion, OH 44833
Phone (419) 462-4547

2981 W 4th St
Ontario, OH 44906
Phone (419) 468-0505

Interoperability endpoints

  • Direct secure messaging: twalker482433@direct.osumc.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1710906219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N SELTZER ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271403",
            "telephone_number": "419-462-4556",
            "fax_number": "419-462-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N SELTZER ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271403",
            "telephone_number": "419-462-4556",
            "fax_number": "419-462-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TERRY",
        "middle_name": "WILLIAM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2201823",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2263161",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000241963",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410049534",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestline, OH

Sources for this page

Verify at the official NPI Registry.