MR. WALTER L JOHNSTON NPI 1215163498

NPI Information

NPI: 1215163498
Provider Name: MR. WALTER L JOHNSTON
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1008 N MAIN ST
SIKESTON, MO
ZIP 63801
Phone: (573) 472-6003
Get Directions

MR. Walter L Johnston is a family nurse practitioner in Sikeston, MO with 20 years of experience. MR. Walter L Johnston NPI is 1215163498. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1008 N MAIN ST
SIKESTON, MO
ZIP 63801-044
Phone: (573) 472-6003
Fax: (573) 472-6006

The NPI 1215163498 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2009 and was last updated on 4/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	2002018631	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1215163498	OTHER	MISSOURI	TRIWEST
2	1215163498	MEDICAID	ILLINOIS
3	1215163498	MEDICAID	MISSOURI
4	A03110	OTHER	MISSOURI	HEALTHLINK
5	177521	OTHER	MISSOURI	HEALTH ALLIANCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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