Individual provider Active NPI

Walter Tyler Winders, M.D.

  • Emergency Medicine Physician
  • Hannibal, MO
National Provider Identifier
1841532041
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2018005253 Issued in MO
Practice address
6000 Hospital Drive
Emergency Dept.
Hannibal, MO 63401
Phone
(573) 248-5100
Fax
(573) 248-5112
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 57.022593 OH
Emergency Medicine Physician 207P00000X 41085 SC
Hospitalist Physician 208M00000X 2018005253 MO
Emergency Medicine Physician 207P00000X 2018005253 MO Primary

Addresses

Primary practice location

6000 Hospital Drive
Emergency Dept.
Hannibal, MO 63401

Mailing address

PO Box 551
Hannibal, MO 63401
Phone (573) 248-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160511000573 OH Practitioner - Emergency Medicine 7214179704 Reassigns benefits to 1 organization
I20170726001587 SC Practitioner - Emergency Medicine 7214179704 Reassigns benefits to 1 organization
I20180604001193 MO Practitioner - Emergency Medicine 7214179704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Vanderbilt University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018005253MOMDEmergency Medicine Physician
57.022593OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Mar 23, 2016 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Emergency Medicine CurrentSince Jun 28, 2017 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 28, 2017 Accepting new patients
Hannibal Regional Healthcare System Inc CurrentSince Jun 14, 2018 Accepting new patients
Hannibal Regional Healthcare System, Inc PastSince Oct 17, 2021 Accepting new patients

Locations

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

169 Ashley Ave
Ste 300
Charleston, SC 29425

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1841532041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-248-5100",
            "fax_number": "573-248-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DRIVE",
            "address_2": "EMERGENCY DEPT.",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-248-5100",
            "fax_number": "573-248-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDERS",
        "first_name": "WALTER",
        "middle_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "57.022593",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "41085",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018005253",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2018005253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.