Individual provider Active NPI

Walter Akwo

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1003119116
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61256413 Issued in WA
Practice address
10710 Evergreen Way Apt G207
Everett, WA 98204-4332
Phone
(408) 806-3840
NPI assigned
Dec 10, 2010
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1053215 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61256413 WA Primary

Addresses

Primary practice location

10710 Evergreen Way Apt G207
Everett, WA 98204-4332

Mailing address

3051 Colonial Way Apt 8
San Jose, CA 95128-4311
Phone (408) 806-3840

Other practice location 1

793 Bosley
Fate, TX 75087-0227
Phone (408) 806-3840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220210002507 WA Practitioner - Nurse Practitioner 5193118370 Reassigns benefits to 1 organization
I20230208003071 TX Practitioner - Nurse Practitioner 5193118370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychcare of Dallas I PLLCGroup PAC ID 2466625371, 46 clinicians

Practice addresses (Care Compare)

150 47TH St SE
Heritage House at Paris Rehab and Nursing
Paris, TX 75462-7417
Phone (903) 784-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 27, 2022 Accepting new patients
Gracepoint Psychiatry and Wellness Services LLC Psychiatric/Mental Health CurrentSince Feb 8, 2023 Accepting new patients
Senior Psychcare of Dallas I, PLLC Psychiatric/Mental Health CurrentSince May 22, 2023 Accepting new patients
Prodigy Home Health & Hospice Care LLC PastSince Oct 1, 2021 Accepting new patients
Crescent Outpatient and Wellness PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1900 Oneal St
Gainesville, TX 76240
Phone (940) 665-2826

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

4200 Shepherd Ln
Mesquite, TX 75180
Phone (972) 286-0335

150 47th St SE
Paris, TX 75462
Phone (903) 784-3100

7146 Baker Blvd
Richland Hills, TX 76118
Phone (817) 589-1734

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1003119116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 COLONIAL WAY APT 8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284311",
            "telephone_number": "408-806-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 EVERGREEN WAY APT G207",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982044332",
            "telephone_number": "408-806-3840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "793 Bosley",
            "address_purpose": "LOCATION",
            "city": "Fate",
            "state": "TX",
            "postal_code": "750870227",
            "country_code": "US",
            "telephone_number": "408-806-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKWO",
        "first_name": "WALTER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-10",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1053215",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61256413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.