Individual provider Active NPI

Phillip A Walker, O.D.

  • Optometrist
  • Edmond, OK
National Provider Identifier
1982757829
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OK0852 Issued in OK
Practice address
16135 North May Ave
Suite a
Edmond, OK 73013-0000
Phone
(405) 751-5638
Fax
(405) 752-1692
NPI assigned
Jan 22, 2007
Last updated
Mar 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OK0852 OK Primary
Corneal and Contact Management Optometrist 152WC0802X 852 OK
Sports Vision Optometrist 152WS0006X 852 OK
Occupational Vision Optometrist 152WX0102X 852 OK
Orthoptist 156FX1900X 852 OK

Addresses

Primary practice location

16135 North May Ave
Suite a
Edmond, OK 73013-0000

Mailing address

16135 North May Ave
Suite a
Edmond, OK 73013-0000
Phone (405) 751-5638

Other identifiers 2

IdentifierTypeStateIssuer
OKAAA3556OtherOKPTAN
730983594001OtherOKBLUE CROSS BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
852OKMDMarriage & Family Therapist
OK0852OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip a. Walker O.D. Inc. Optometrist PastSince Jun 1, 1972 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1982757829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16135 NORTH MAY AVE",
            "address_2": "SUITE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730130000",
            "telephone_number": "405-751-5638",
            "fax_number": "405-752-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16135 NORTH MAY AVE",
            "address_2": "SUITE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730130000",
            "telephone_number": "405-751-5638",
            "fax_number": "405-752-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "OK0852",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "852",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OK",
            "license": "852",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OK",
            "license": "852",
            "primary": false
        },
        {
            "code": "156FX1900X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Orthoptist",
            "state": "OK",
            "license": "852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "OKAAA3556",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730983594001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.