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WALTER THOMAS WISWELL
NPI 1215469382
Student in an Organized Health Care Education/Training Program in Jacksonville, FL

Active since March 29, 2017PECOS EnrolledAccepts Medicare Assignment
1818 VALENCIA DR, JACKSONVILLE, FL 32207(904) 434-6281 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2021, Mar 29, 2017 (2 updates tracked since 2017).

About Walter Thomas Wiswell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALTER THOMAS WISWELL (NPI 1215469382) is an individual student in an organized health care education/training program in Jacksonville, Florida and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (2017).

NPPES Registry Identity

NPI1215469382
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameWALTER THOMAS WISWELL
Location Address1818 VALENCIA DRJacksonville, FL 32207-2533
Mailing Address1818 Valencia DrJacksonville, FL 32207-2533 · (904) 434-6281
Phone(904) 434-6281
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 2017
Enumeration DateMarch 29, 2017
Last NPPES UpdateDecember 21, 20212 updates tracked since enumeration
✔ NPI 1215469382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1818 VALENCIA DR, Jacksonville, FL 32207
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Walter Thomas Wiswell is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850708884
PECOS Enrollment IDI20210318001538
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
21 services21 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walter Wiswell's NPI number?

The NPI number for Walter Wiswell is 1215469382. It was assigned to this individual provider in the NPPES registry on March 29, 2017.

Where is Walter Wiswell located?

Walter Wiswell practices at 1818 Valencia Dr, Jacksonville, FL 32207. The listed phone number is (904) 434-6281.

What is Walter Wiswell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Walter Wiswell enrolled in Medicare?

Yes. Walter Wiswell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Walter Wiswell was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.