Daniel L Walrath, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22567 Issued in WI

Practice address

240 Maple Ave
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149-8475

Phone

(262) 929-1900

Fax

(262) 363-1949

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1891757555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-929-1900",
            "fax_number": "262-363-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-929-1900",
            "fax_number": "262-363-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALRATH",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "22567",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "22567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30372200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer K Vitek Semrad, APNP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Jane L. Walloch, M.D.
• Kimberly Heather Washington, MA, LPC
• Becky Lynn Watral, OTR
• Waukesha Health System Inc
• Waukesha Health System, Inc
• Amy Beth Weast, MSW, LCSW

• Family Medicine Physician in Mukwonago, WI
• Providers in Mukwonago, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.