Active NPI
Walter Rand Walker, PH.D.
- Clinical Psychologist
- Moscow, ID
National Provider Identifier
1730238445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY281
- Practice address
- 2301 W a St Ste C
Moscow, ID 83843-4042 - Phone
- (208) 883-1144
- Fax
- (208) 883-8062
- NPI assigned
- Jan 10, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY281 | ID | Primary |
Addresses
Primary practice location
2301 W a St Ste C
Moscow, ID 83843-4042
Mailing address
2301 West a Street Suite C
Moscow, ID 83843
Phone (208) 883-1144
Other names 1
- Dr. W. Rand Walker
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 21, 2024 through Aug 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY281 | ID | MD | Clinical Psychologist |
| 281 | ID | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Educational and Psychological Services, a P.L.L.C. | Clinical | Past | Accepting new patients |
| Bloomin Family Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Moscow, ID
- NPI 1447303870
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Moscow, ID
- NPI 1457036436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730238445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 WEST A STREET SUITE C",
"city": "MOSCOW",
"state": "ID",
"postal_code": "83843",
"telephone_number": "208-883-1144",
"fax_number": "208-883-8062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 W A ST STE C",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838434042",
"telephone_number": "208-883-1144",
"fax_number": "208-883-8062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "WALTER",
"middle_name": "RAND",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ID",
"license": "PSY281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "W.",
"last_name": "WALKER",
"middle_name": "RAND",
"prefix": "DR.",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.