DAVID CLAYTON WALTHALL (NPI# 1619477965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619477965 |
| Entity Type | Individual |
| Full Name | DAVID CLAYTON WALTHALL |
| Credential | FNP, MSN, BSN |
| Practice Address |
1340 S Damen Ave Chicago IL 60608-1169 |
| Practice Telephone | 3129977200 |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.017198 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477760122 | David Barclay Walthall IIi | Family Medicine | 541 Walnut Ave, Waynesboro, VA 22980 | 2007-05-16 |
| Street Address |
1340 S DAMEN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60608-1169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811998438 | Home Physicians PC | Podiatrist | 1340 S Damen Ave, Suite 210, Chicago, IL 60608-1169 | 2005-08-04 |
| 1649722174 | Sonja Boone | Internal Medicine | 1340 S Damen Ave, Suite 400, Chicago, IL 60608-1169 | 2016-11-01 |
| 1982093738 | Melissa Louise Hetzel | Registered Nurse | 1340 S Damen Ave, Suite 400, Chicago, IL 60608-1169 | 2015-01-16 |
| 1265830442 | Thelma Michelle Holt-nicholson | Nurse Practitioner | 1340 S Damen Ave, Chicago, IL 60608-1169 | 2014-12-20 |
| 1043614597 | Kavitha Wagner | Nurse Practitioner | 1340 S Damen Ave, Suite 400, Chicago, IL 60608-1169 | 2014-10-13 |
| 1982007878 | Christine Agostino | Registered Nurse | 1340 S Damen Ave, Suite 210, Chicago, IL 60608-1169 | 2014-10-06 |
| 1952703795 | Deborah M Bryant | Registered Nurse | 1340 S Damen Ave, Suite 210, Chicago, IL 60608-1169 | 2014-09-24 |
| 1851700637 | Chiriss Mcgraw | Nurse Practitioner | 1340 S Damen Ave, Chicago, IL 60608-1169 | 2014-08-06 |
| 1780012245 | Robin Anderson | Nurse Practitioner | 1340 S Damen Ave, Chicago, IL 60608-1169 | 2013-10-21 |
| 1316389570 | Sheridan Keeter | Nurse Practitioner | 1340 S Damen Ave, Ste 210, Chicago, IL 60608-1169 | 2013-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390047 | Bethuna Shields | Occupational Therapist | 1401 South California Ave, Chicago, IL 60608 | 2020-06-11 |
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1205481058 | Joshua Hartman | Pharmacist | 345 Csb Mc 884, 840 S. Wood St, Chicago, IL 60608 | 2019-08-08 |
| 1194386706 | Mount Sinai Hospital, Chicago | Internal Medicine | Mount Sinai Hospital, 1500 S Fairfield Ave, Chicago, IL 60608 | 2019-06-25 |
| 1841754256 | Julia Bates | Occupational Therapist | 1640 W. Roosevelt Rd., 415 Dhsp (mc 726), Chicago, IL 60608 | 2019-01-30 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1114412970 | Dmitri Zbarsky | Internal Medicine | 1500 South Fairfield Ave., F-914, Chicago, IL 60608 | 2018-06-25 |
| 1740773050 | Alexia Ilian Derma Salazar | Speech-Language Pathologist | 2301 W 19th St - 3rd Floor Rear, Chicago, IL 60608 | 2018-06-11 |
| 1912424730 | Pareen Modi | Pharmacist | 2539 South Western Avenue, Chicago, IL 60608 | 2017-08-23 |
| 1952824302 | Raquel Gonzalez Heredia | Surgery | 1500 South Fairfield Ave, Chicago, IL 60608 | 2017-07-18 |
| Find all providers in zip 60608 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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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.