Active NPI
Raymond Roy Walston III, M.D.
- Pediatric Hematology & Oncology Physician
- Aurora, CO
National Provider Identifier
1790176873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- DR0071417
- Practice address
- 13123 E 16TH Ave
Aurora, CO 80045-7106 - Phone
- (720) 777-6688
- NPI assigned
- Feb 11, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Hematology & Oncology Physician | 2080P0207X | DR0071417 | CO | Primary |
| Pediatrics Physician | 208000000X | 23529 | NH |
Addresses
Primary practice location
13123 E 16TH Ave
Aurora, CO 80045-7106
Mailing address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234
Other practice location 1
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000
Other practice location 2
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone (757) 953-2958
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR0071417 | CO | MD | Pediatric Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Colorado | Current | Accepting new patients |
Locations
13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846
Interoperability endpoints
- rwalston265691@direct.childrenscolorado.org
Organizations & group practices 1
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 Social Worker
- Aurora, CO
- NPI 1174282776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1790176873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-6688"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "NH",
"postal_code": "037561000",
"country_code": "US",
"telephone_number": "603-650-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "620 John Paul Jones Circle",
"address_purpose": "LOCATION",
"city": "Portsmouth",
"state": "VA",
"postal_code": "23708",
"country_code": "US",
"telephone_number": "757-953-2958",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALSTON",
"first_name": "RAYMOND",
"middle_name": "ROY",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-11",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "CO",
"license": "DR0071417",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NH",
"license": "23529",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.