Ralph E Waldo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01057531A Issued in IN

Practice address

703 Pro-Med LN
Suite 200
Carmel, IN 46032-5317

Phone

(317) 843-9922

Fax

(317) 581-3918

NPI assigned

Jul 26, 2006

Last updated

May 6, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 11, 2017 through May 11, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fawver Waldo Clinic LLP

  • Adolescent and Children Mental Health Clinic/Center
  • Fort Wayne, IN
  • NPI 1174536346
  NPD (past)
• Indiana Health Group Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1356396295

  Psychiatry

  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Psychiatric Innovations PC

  dba Fawver Wellness Clinic

  • Psychiatry Physician
  • Fort Wayne, IN
  • NPI 1578583910
  NPD (past)
• St Joseph Medical Group Inc

  • General Practice Physician
  • Fort Wayne, IN
  • NPI 1811952070

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1760405963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "address_2": "SUITE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "address_2": "SUITE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "RALPH",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "71000700A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01057531A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Rollin Wakeland, MD
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1601)
• Wal-Mart Stores East, LP (Vision Center 30-1601)
• Wal-Mart Stores East, LP (Vision Center 30-1601)
• Breanna Walden, IWLC
• Walgreen Co (Walgreens #06165)
• Walgreen Co (Walgreens #15334)
• Jessicah Dawn Walker Herche, PHD, HSPP
• Andrew J Walker, PA-C
• April Walker

• Psychiatry Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.