Active NPI
William Emmett Walsh, M.D.
- Allergy & Immunology Physician
- Saint Paul, MN
National Provider Identifier
1790783652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 17304
- Practice address
- 1690 University Ave W
Suite 450
Saint Paul, MN 55104-3723 - Phone
- (651) 645-8182
- Fax
- (651) 649-3509
- NPI assigned
- Jul 13, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 17304 | MN | Primary |
Addresses
Primary practice location
1690 University Ave W
Suite 450
Saint Paul, MN 55104-3723
Mailing address
990 Lydia Dr W
Roseville, MN 55113-1923
Phone (651) 483-1124
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 |
|---|---|---|---|
| 17304 | MN | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healtheast Medical Research Institute | Past | Accepting new patients | |
| Adult and Child Allergy, P.a. | Allergy & Immunology | 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.
-
- Allergy & Immunology Physician
- Saint Paul, MN
- NPI 1154341618
-
- Internal Medicine Physician
- Saint Paul, MN
- NPI 1508191552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790783652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 LYDIA DR W",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131923",
"telephone_number": "651-483-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1690 UNIVERSITY AVE W",
"address_2": "SUITE 450",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043723",
"telephone_number": "651-645-8182",
"fax_number": "651-649-3509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "WILLIAM",
"middle_name": "EMMETT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "MN",
"license": "17304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.