Nicole Pearl Walton, PA-C
Individual provider Active NPI Physician Assistant · Hughesville, PA
NPI 1083945893 · NPPES record last updated Apr 30, 2019
Key facts
- NPI
- 1083945893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- MA054291 (PA)
- Practice address
- 246 S Main St
Hughesville, PA 17737-1614 - Phone
- (570) 584-5144
- Fax
- (570) 584-4651
- NPI assigned
- Jan 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Practice Center PC
Practice addresses (Care Compare)
1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-5889
1205 River Ave
Williamsport, PA 17701-3724
246 S Main St
Hughesville, PA 17737-1614
Phone (570) 584-5144
Hospital & facility affiliations
- Upmc Williamsport
- Upmc Muncy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100309000361 | PA | Practitioner - Physician Assistant | 1658416151 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Practice Center, PC | Physician Assistant | Current |
Accepting new patients |
Locations
246 S Main St
Hughesville, PA 17737
Phone (570) 584-5144
7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123
270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703
Interoperability endpoints
- nicolewaltonpa@fpc.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA054291 | PA | Yes |
Addresses
Primary practice location
246 S Main St
Hughesville, PA 17737-1614
Mailing address
7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1031848620001 | Medicaid | PA |
Other names
- Nicole Pearl Knight
Other providers in Hughesville, PA
- Jacquelyn E Smith
- Amanda Swink
- Sarah Taylor
- Tonya Ann Valentine
- Robert Scott Van Ess
- Allen Anthony Wetzel
- Barbara Jean Whitmoyer
- Angela Oakes Withee
All providers in Hughesville, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.