Matthew James Walker, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2010016171 Issued in MO

Practice address

1724 Nebraska Ave
BLDG 1608
Fort Leonard Wood, MO 65473-8939

Phone

(573) 596-0388

Fax

(573) 596-0410

NPI assigned

Oct 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• River City Endodontics

  • Endodontics
  • O'Fallon, MO
  • NPI 1043899677
  NPD Authorized official

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1730499187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 NEBRASKA AVE",
            "address_2": "BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0388",
            "fax_number": "573-596-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 NEBRASKA AVE",
            "address_2": "BLDG 1608",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738939",
            "telephone_number": "573-596-0388",
            "fax_number": "573-596-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010016171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Hendrik Verhoef, PT, DPT
• Debra L Vine
• Samantha L Visser, L.P.N.
• Patricia Anh Thu Vu, MD, PHD
• Katherine L. Waldron, LCSW
• Lisa M Walton, LCSW
• Jessica Ward, O.D.
• Steven Randall Ward, PA-C
• Lachell Wardell, PHARMD
• John Waszak

• Dentist in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.