Gregory L Walter, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104000425 Issued in VA

Practice address

5219 Peters Creek Rd NW
Suite 5
Roanoke, VA 24019-3864

Phone

(540) 362-0811

Fax

(540) 362-5025

NPI assigned

Jun 21, 2005

Reactivated

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Walter Chiropractic Clinic

  • Chiropractor
  • Roanoke, VA
  • NPI 1275609331
  NPD (past) Authorized official

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1902802457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8521 BARRENS RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240196705",
            "telephone_number": "540-563-0487",
            "fax_number": "540-362-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 PETERS CREEK RD NW",
            "address_2": "SUITE 5",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240193864",
            "telephone_number": "540-362-0811",
            "fax_number": "540-362-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "GREGORY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2010-06-09",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "018116",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Walls, PHARMD
• Walnut Avenue Associates PC
• Sonnie C Walsh, LPTA
• Walter B. Blair,M.D., Inc
• Walter Chiropractic Clinic
• Melanie Rebecca Walter, M.D.
• Jacob Keith Walters, PHARMD
• David Clark Walton, M.D.
• Benjamin Bin Wang, O.D.
• Kenten Pey-Kuen Wang, D.O.

• Chiropractor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.