MR. MICHAEL SHANE WALTERS (NPI# 1386817294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386817294 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL SHANE WALTERS |
| Credential | MD, MPH |
| Practice Address |
1001 E Primrose St Springfield MO 65807-5155 |
| Mailing Address |
Po Box 9007 Springfield MO 65808-9007 |
| Practice Telephone | 4178753000 |
| Mailing Telephone | 4178753000 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2018-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
2009005099 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1386817294 | 05 | |
| MO | 206427106 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518472596 | Michael Walters | Registered Nurse | 241 Ravine Bluff Dr, Newark, OH 43055-9212 | 2017-12-12 |
| 1629034475 | Michael A Walters | Physical Therapist | 1439 Swan Ln, Mullica Hill, NJ 08062-3246 | 2006-04-21 |
| 1699388868 | Michael Anthony Walters Jr. | Specialist/Technologist | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2020-08-28 |
| 1891359790 | Michael Walters | Student in an Organized Health Care Education/Training Program | Cleveland Clinic 9500 Euclid Avenue/na-23, Cleveland, OH 44195-0001 | 2019-04-25 |
| 1538602032 | Michael Walters | Respiratory Therapist, Registered | 6900 Pecos Rd, North Las Vegas, NV 89086-4400 | 2016-12-01 |
| 1801346671 | Michael Walters | Counselor | 70 S River St, Aurora, IL 60506-5185 | 2016-10-05 |
| 1316497043 | Michael Walters | Social Worker | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2016-10-05 |
| 1427507599 | Michael Walters | Counselor | 224 Great Bridge Blvd, Chesapeake, VA 23320-3904 | 2016-09-29 |
| 1962768341 | Michael John Walters | Radiology | 4500 S Garnett Rd Ste 300, Tulsa, OK 74146-5238 | 2012-04-10 |
| 1942582648 | Michael Joe Walters | Pharmacist | 1323 N Baldwin Ave, Marion, IN 46952-1913 | 2011-09-19 |
| Street Address |
1001 E PRIMROSE ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915792 | Robert Clayton Scanlon II | Urology | 1001 E Primrose St, Springfield, MO 65807-5155 | 2005-07-07 |
| 1619580537 | Nathaniel Levi Kenady | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2020-08-29 |
| 1891343893 | Connie J Garrett | Dietitian, Registered | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-09-03 |
| 1689236085 | Lindsey Joy Gelber | Dietitian, Registered | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-07-05 |
| 1174186654 | Stephenie Michele Zinter | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-04-19 |
| 1215495650 | Mikel Dashtipour | Physician Assistant | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-03-05 |
| 1043774789 | Arielle M Campbell | Physician Assistant | 1001 E Primrose St, Springfield, MO 65807-5155 | 2019-01-28 |
| 1649755919 | Stephanie Lynn Brown | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-10-02 |
| 1114401312 | Teresa Cunningham | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-09-24 |
| 1336629120 | Katelynne D Haun | Nurse Practitioner | 1001 E Primrose St, Springfield, MO 65807-5155 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528475050 | Bachir Zoghbi | Radiology | 3801 S National Ave, Springfield, MO 65807-5210 | 2014-07-16 |
| 1063674216 | Bryan Su-hyun Jeun | Radiology | 3801 S National Ave, Springfield, MO 65807-5210 | 2008-06-30 |
| 1114033396 | Jason L. Port | Radiology | 3640 Main St, Suite 101, Springfield, MA 01107-1145 | 2006-08-21 |
| 1992818991 | Matthew J. Kuhn | Radiology | 800 E Carpenter St, Department of Radiology, Springfield, IL 62702-5324 | 2006-08-16 |
| 1083675235 | Bryan Keith Hall | Radiology | 3801 S National Ave, Springfield, MO 65807-5210 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629023239 | Sharon K Wallace | Radiology | 70 Doctors' Park, Cape Girardeau, MO 63703 | 2006-05-23 |
| 1386115715 | Ayman Mohamed Nada | Radiology | 1 Hospital Dr, Columbia, MO 65212-0001 | 2018-12-11 |
| 1457832404 | Sudhir Bhimaniya | Radiology | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2018-08-28 |
| 1902293285 | Kasra Rahbar | Radiology | 510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110-1016 | 2015-04-23 |
| 1275947012 | Rahul Pradeep Deolankar | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2014-06-19 |
| 1073923223 | John Td Vu | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2014-04-28 |
| 1477978534 | Carlos Leiva Salinas | Radiology | 1 Hospital Dr, Columbia, MO 65212-0001 | 2014-02-26 |
| 1811330954 | Michael T Bayona | Radiology | 100 Mercy Way, Joplin, MO 64804-4524 | 2013-04-08 |
| 1952663270 | Rami W Eldaya | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2012-06-12 |
| 1992064521 | Ritu Bordia | Radiology | 1201 S Grand Blvd, Saint Louis, MO 63104-1016 | 2012-05-16 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.