Individual provider Active NPI

Larry Dean Walker, PH.D.

  • Psychologist
  • Reno, NV
National Provider Identifier
1982656831
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY0692 Issued in NV
Practice address
85 Kirman Ave Ste 200
Reno, NV 89502-1339
Phone
(775) 982-2862
Fax
(775) 982-2865
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5282 FL
Psychologist 103T00000X PS04738-L PA
Psychologist 103T00000X PSY22181 CA
Psychologist 103T00000X PSY003253 GA
Psychologist 103T00000X PY0692 NV Primary

Addresses

Primary practice location

85 Kirman Ave Ste 200
Reno, NV 89502-1339

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other practice location 1

820 Ebenezer Church Rd Ste 110
Sharpsburg, GA 30277-2073
Phone (706) 889-3997

Other identifiers 2

IdentifierTypeStateIssuer
11388219OtherCAQH
1982656831MedicaidNV

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH5282FLMDMental Health Counselor
PSY22181CAMDPsychologist
PSY003253GAMDPsychologist
PY0692NVMDPsychologist
PS04738-LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: larrywalker@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1982656831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 KIRMAN AVE STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021339",
            "telephone_number": "775-982-2862",
            "fax_number": "775-982-2865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Ebenezer Church Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sharpsburg",
            "state": "GA",
            "postal_code": "302772073",
            "country_code": "US",
            "telephone_number": "706-889-3997",
            "fax_number": "888-501-7276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LARRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5282",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS04738-L",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22181",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003253",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY0692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11388219",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982656831",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.