Active NPI
Kurt J Walck, PHARM.D.
- Pharmacist
- Clarksburg, WV
National Provider Identifier
1972198539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA.0023286
- Practice address
- 1 Medical Center Drive
Clarksburg, WV 26301 - Phone
- (304) 623-3461
- NPI assigned
- Mar 5, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA.0023286 | CO | Primary |
Addresses
Primary practice location
1 Medical Center Drive
Clarksburg, WV 26301
Mailing address
422 S 6TH St
Clarksburg, WV 26301-3624
Phone (570) 423-4536
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA.0023286 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1972198539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 S 6TH ST",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263013624",
"telephone_number": "570-423-4536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DRIVE",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "26301",
"telephone_number": "304-623-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCK",
"first_name": "KURT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-05",
"last_updated": "2021-03-05",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA.0023286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.