LARRY R WALTON (NPI# 1063440311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063440311 |
| Entity Type | Individual |
| Full Name | LARRY R WALTON |
| Practice Address |
1220 West Milham Ave Portage MI 49024-1206 |
| Practice Telephone | 2693829900 |
| Practice Fax Number | 2693820700 |
| Mailing Telephone | 2693829900 |
| Mailing Fax Number | 2693820700 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-08-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 039773 | MI | Other Service Providers |
| N | 335E00000X | Prosthetic/Orthotic Supplier | 039773 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4079644 | 05 | |
| MI | BCBS PROVIDER ID | 039279 | 01 |
| Street Address |
1220 WEST MILHAM AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790989549 | Larry R Walton | Prosthetic/Orthotic Supplier | 1220 West Milham Ave, Portage, MI 49024-1206 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679010342 | Kathryn Dittmer | Specialist | 3411 Airport Rd, Portage, IN 46368-5107 | 2017-01-19 |
| 1154875854 | Toni Latham | Specialist | 3215 Stonebridge Ct, Apt. 9, Portage, MI 49024-8000 | 2016-08-10 |
| 1194999896 | Lakeshore Bone & Joint Institute, PC | Specialist | 3691 Willowcreek Rd, Portage, IN 46368-5076 | 2008-04-15 |
| 1093924615 | Christine Jubina | Specialist | 394 Golf Course Rd, Portage, PA 15946-6018 | 2007-05-21 |
| 1245452481 | Plastic Surgery of Kalamazoo,pc | Specialist | 7901 South 12th Street, Suite 100, Portage, MI 49024 | 2007-05-03 |
| 1891914867 | Hickner Eye Center, P.C. | Specialist | 1906 W Milham Ave, Portage, MI 49024 | 2007-04-25 |
| 1740308964 | David R Areaux | Specialist | West Michigan Ear, Nose & Throat, 3850 Glenkerry Court, Portage, MI 49024 | 2007-03-26 |
| 1104277672 | Samantha Kohn | Specialist | 9616 Portage Rd, Portage, MI 49002-7257 | 2016-06-27 |
| 1164873618 | Hannah Patricia Christensen | Specialist | 9616 Portage Rd, Portage, MI 49002-7257 | 2016-06-27 |
| 1558712935 | Ayanna Frazier | Specialist | 9616 Portage Rd, Portage, MI 49002-7257 | 2016-06-27 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.