Active NPI
Julian Walters, MD
- Psychosomatic Medicine Physician
- Gainesville, FL
National Provider Identifier
1093925489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychosomatic Medicine Physician
- License
- 77433
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3003 - Phone
- (352) 265-0111
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychosomatic Medicine Physician | 2084P0015X | 77433 | AZ | Primary |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3003
Mailing address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-0111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77433 | Other | AZ | TRAINING LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77433 | AZ | MD | Psychosomatic Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248048000000",
"number": "1093925489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-265-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-265-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "JULIAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2009-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0015X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychosomatic Medicine",
"state": "AZ",
"license": "77433",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAINING LICENSE",
"identifier": "77433",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.