Perry T Walters, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

1545581205 Issued in UT

Practice address

425 Medical Dr
Suite 112
Bountiful, UT 84010

Phone

(801) 292-7249

Fax

(801) 292-7251

NPI assigned

Dec 8, 2006

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Perry T. Walters, M.D. PC

  • Urology Physician
  • Bountiful, UT
  • NPI 1083922926
  NPD (past) Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1790844165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DR",
            "address_2": "SUITE 112",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-292-7249",
            "fax_number": "801-292-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DR",
            "address_2": "SUITE 112",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-292-7249",
            "fax_number": "801-292-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "PERRY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "1545581205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Wall, LCMHC
• Anthony R. Wallin, MD
• Jeffrey Scott Walsh
• Jessica Walters, CSW
• Megan Marie Walters
• Yekaterina Walther
• Ruth Jensen Walton, MOT
• Kristine Ward, COTA
• Nathan C Ward, MD
• Olivia Ivy Ward, CSW

• Urology Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Urology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.