Active NPI
Michael Walton, LCAS
- Addiction (Substance Use Disorder) Counselor
- Burgaw, NC
National Provider Identifier
1912378811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 20516
- Practice address
- 309 Progress Dr
Burgaw, NC 28425-3280 - Phone
- (102) 590-6689
- Fax
- (910) 202-9966
- NPI assigned
- Oct 18, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20516 | NC | Primary |
Addresses
Primary practice location
309 Progress Dr
Burgaw, NC 28425-3280
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 202-5709
Other practice location 1
803 S Walker St
Burgaw, NC 28425-5001
Phone (910) 259-0668
Other practice location 2
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 202-5709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 191237881 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20516 | NC | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651104000000",
"number": "1912378811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-202-5709",
"fax_number": "910-202-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 PROGRESS DR",
"city": "BURGAW",
"state": "NC",
"postal_code": "284253280",
"telephone_number": "102-590-6689",
"fax_number": "910-202-9966"
}
],
"practiceLocations": [
{
"address_1": "803 S Walker St",
"address_purpose": "LOCATION",
"city": "Burgaw",
"state": "NC",
"postal_code": "284255001",
"country_code": "US",
"telephone_number": "910-259-0668",
"fax_number": "910-259-4526",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "615 Shipyard Blvd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284126431",
"country_code": "US",
"telephone_number": "910-202-5709",
"fax_number": "910-202-9966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTON",
"first_name": "MICHAEL",
"credential": "LCAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-18",
"last_updated": "2022-04-28",
"certification_date": "2022-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "20516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "191237881",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burgaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.