Robert Edmund Walter, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14050 Issued in TN

Practice address

1505 W Elk Ave
Suite 2
Elizabethton, TN 37643-2848

Phone

(423) 543-1261

Fax

(423) 543-7500

NPI assigned

Oct 13, 2006

Last updated

Feb 28, 2017By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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.

Enrollment records 1

Specialty

Internal Medicine

Education

Medical College of Georgia School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Neurological Surgery Physician
  • Johnson City, TN
  • NPI 1003152307
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD

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

• Mountain States Health Alliance

  dba Sycamore Shoals Hospital

  • General Acute Care Hospital
  • Elizabethton, TN
  • NPI 1891801734
  Care Compare affiliation

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1780774570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W ELK AVE",
            "address_2": "SUITE 2",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432848",
            "telephone_number": "423-543-1261",
            "fax_number": "423-543-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W ELK AVE",
            "address_2": "SUITE 2",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432848",
            "telephone_number": "423-543-1261",
            "fax_number": "423-543-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ROBERT",
        "middle_name": "EDMUND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "TN",
            "license": "MD0000014050",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "14050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3195327",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP (Vision Center 30-0690)
• Walgreen Co (Rite Aid #17985)
• Walgreen Co (Walgreens #09429)
• Emma Micaela Walker
• Rebecca Lynn Walker, PA-C
• Ward Chiropractic Center PC
• Charley Franz Ward, D.C.
• Roger Lee Ward, D.C.
• Lelia Waycaster, OTR/L
• Trever Weaver

• Internal Medicine Physician in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.