Individual provider Active NPI

Matthew Anthony Walker, MD

  • Emergency Medicine Physician
  • London, OH
National Provider Identifier
1992900419
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301084424 Issued in MI
Practice address
210 N Main St
London, OH 43140-1115
Phone
(513) 284-3019
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301084424 MI Primary

Addresses

Primary practice location

210 N Main St
London, OH 43140-1115

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (513) 284-3019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000080 OH Practitioner - Emergency Medicine 6608957949 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301084424MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mahoning Valley Emergency Specialists LLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Mves Boardman LLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Mves Austintown LLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients
Samaritan Emergency Corp Emergency Medicine Past Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1950 Niles Cortland Rd NE
Warren, OH 44484
Phone (234) 600-5752

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

6252 Mahoning Ave
Youngstown, OH 44515
Phone (330) 792-7418

Organizations & group practices 6

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1992900419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "513-284-3019",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431401115",
            "telephone_number": "513-284-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MATTHEW",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301084424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, OH

Sources for this page

Verify at the official NPI Registry.