Active NPI
Karen Marie Waltz, MD
- Dermatology Physician
- York, PA
National Provider Identifier
1114142254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD061740L
- Practice address
- 1934 Security Drive
York, PA 17402 - Phone
- (717) 741-3761
- Fax
- (717) 741-9495
- NPI assigned
- Apr 16, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD061740L | PA | Primary |
Addresses
Primary practice location
1934 Security Drive
York, PA 17402
Mailing address
69 Brookview Drive
Lititz, PA 17543
Phone (717) 741-3761
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133197 | Other | PA | BLUE SHIELD LEGACY NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195171200000",
"number": "1114142254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 BROOKVIEW DRIVE",
"city": "LITITZ",
"state": "PA",
"postal_code": "17543",
"telephone_number": "717-741-3761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1934 SECURITY DRIVE",
"city": "YORK",
"state": "PA",
"postal_code": "17402",
"telephone_number": "717-741-3761",
"fax_number": "717-741-9495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTZ",
"first_name": "KAREN",
"middle_name": "MARIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2007-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MD061740L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD LEGACY NUMBER",
"identifier": "133197",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.