DR. DAVID C WALTERS (NPI# 1114093986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114093986 |
| Entity Type | Individual |
| Full Name | DR. DAVID C WALTERS |
| Credential | M.D. |
| Practice Address |
1407 Mcpherson Ave Mount Vernon IL 62864-2822 |
| Mailing Address |
3408 Office Park Dr Marion IL 62959-6477 |
| Practice Telephone | 6189975266 |
| Practice Fax Number | 6188999010 |
| Mailing Telephone | 6189975266 |
| Mailing Fax Number | 6189975285 |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2014-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 036090694 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | 160050342 | 01 |
| IL | HEALTHLINK | 381348 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 4126931 | 01 |
| IL | 036090694 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821630336 | David Rodwell Walters II | Specialist/Technologist | 112 Twelve Mile Dr, Lexington, SC 29072-3964 | 2019-10-16 |
| 1679695779 | David Joe Walters | Chiropractor | 226 Love Street, Erwin, TN 37650 | 2007-04-06 |
| 1609832799 | David Lee Walters | Family Medicine | 7979 W Virginia Dr, Dallas, TX 75237-3798 | 2006-04-26 |
| 1306827076 | David L Walters | General Practice | 217 S Main St, Fowler, CO 81039-1132 | 2005-11-09 |
| 1295135168 | David Walters | Specialist/Technologist | 2700 Robert T Longway Blvd, Suite C, Flint, MI 48503-2190 | 2014-08-28 |
| 1134557929 | David A Walters | Social Worker | 31891 State Route 93, Mc Arthur, OH 45651-9006 | 2013-10-15 |
| 1275858326 | David T Walters | Counselor | 25111 Country Club Blvd, Suite 290, North Olmsted, OH 44070-5345 | 2010-04-01 |
| 1184865727 | David R Walters | Specialist/Technologist, Other | 5716 Hickory Plz, Suite 200, Nashville, TN 37211-8546 | 2009-03-11 |
| 1093938615 | David Michael Walters | Otolaryngology | 2300 Manchester Expy, Suite C003, Columbus, GA 31904-6802 | 2007-04-11 |
| 1053408096 | David Northern Walters | Surgery | James H. Quillen/vamc, Corner of Sidney and Lamont, Johnson City, TN 37684 | 2006-10-10 |
| Street Address |
1407 MCPHERSON AVE |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043852932 | Heartland Women's Healthcare Ltd | Clinical Medical Laboratory | 1407 Mcpherson Ave, Mount Vernon, IL 62864-2822 | 2019-10-11 |
| 1164938882 | Karie Stewart | Midwife | 1407 Mcpherson Ave, Mount Vernon, IL 62864-2822 | 2017-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972882850 | Jba Women's Medical PC | Obstetrics & Gynecology | 129 Urban St, Mount Vernon, NY 10552-3211 | 2011-08-10 |
| 1487872388 | Mount Vernon Womens Clinc Inc Ps | Obstetrics & Gynecology | 111 N. 17th Street, Mount Vernon, WA 98273 | 2007-04-23 |
| 1730257924 | Emily Beth Boyd | Obstetrics & Gynecology | 3130 Veterans Memorial Dr, Mount Vernon, IL 62864-5951 | 2006-12-04 |
| 1912073784 | Womens Health Associates of Southern Illinois, S. C. | Obstetrics & Gynecology | 1708 Jefferson Ave, Mount Vernon, IL 62864-4309 | 2006-11-25 |
| 1326129339 | Nonyelu Iruoma Anyichie | Obstetrics & Gynecology | 105 Stevens Ave Ste 209, Mount Vernon, NY 10550-2682 | 2006-10-17 |
| 1609816578 | Edward Amelmah | Obstetrics & Gynecology | 107 West 4th Street, Mount Vernon, NY 10550 | 2006-06-07 |
| 1174599682 | Marise St. Charles | Obstetrics & Gynecology | 100 Stevens Ave, 7th Floor, Mount Vernon, NY 10550-2600 | 2006-02-24 |
| 1639143555 | Sara C. Rowland | Obstetrics & Gynecology | 111 N 17th St, Mount Vernon, WA 98273-3440 | 2006-02-15 |
| 1871567792 | Daniel C. Bynum | Obstetrics & Gynecology | 215 S 13th St, Mount Vernon, WA 98274-4107 | 2006-02-15 |
| 1336125343 | Melissa S Chinn | Obstetrics & Gynecology | 111 S 12th St, Mount Vernon, WA 98274-4000 | 2005-12-21 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on DR. DAVID C WALTERS.
| 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.