Meredith Walton OD, Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

14770TLG Issued in CA

Legal business name

MEREDITH WALTON OD, OPTOMETRIC CORPORATION

Practice address

3404 Adams Ave
San Diego, CA 92116-2428

NPI assigned

Jul 3, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Meredith Grace Walton, ODNPI 1497027528

Title

President

Phone

(619) 431-5393

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meredith Grace Walton, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1497027528
  Medicare reassignment Care Compare group Authorized official
• Crizelda Lauron, O.D.

  • Optometrist
  • San Rafael, CA
  • NPI 1033513742
  Medicare reassignment Care Compare group NPD
• Rachel Lee, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1619379278
  Medicare reassignment Care Compare group NPD
• Andreea Nastasoiu, OD

  • Optometrist
  • National City, CA
  • NPI 1487209268
  Medicare reassignment Care Compare group NPD
• Chantelle Verduzco Davis, OD

  • Optometrist
  • San Diego, CA
  • NPI 1235615014
  Medicare reassignment Care Compare group NPD
• Jack Ibrahim, OD

  • Optometrist
  • Cedar Hill, TX
  • NPI 1760978571

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1801317672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162428",
            "telephone_number": "619-431-5393",
            "fax_number": "619-432-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3068 University Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921043034",
            "country_code": "US",
            "telephone_number": "619-298-5524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEREDITH WALTON OD, OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-431-5393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14770TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1033513742",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mercy Vascular, a Professional Medical Corporation
• Stephanie Josette Mereday
• Bess Joy Meredith
• Janet Markwordt Meredith, RPH-BS PHARMACY
• Michelle Lea Meredith, P.A.-C
• Rachel Andrea Meredith
• Randy Meredith

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.