NPIMap

Organization Active NPI

Kids Health Place

  • Pediatrics Physician
  • Fort Pierce, FL
National Provider Identifier
1124036819
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDS HEALTH PLACE
Practice address
2900 W Midway Rd
Fort Pierce, FL 34981-4955
Phone
(772) 467-0961
Fax
(772) 467-6683
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Garth Walters, MDNPI 1356381446
Title
President
Phone
(772) 467-0961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X FL Primary

Addresses

Primary practice location

2900 W Midway Rd
Fort Pierce, FL 34981-4955

Mailing address

2900 W Midway Rd
Fort Pierce, FL 34981-4955
Phone (772) 467-0961

National Provider Directory

National Provider Directory

Locations

2900 W Midway Rd
Fort Pierce, FL 34981
Phone (772) 467-0961

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124036819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814955",
            "telephone_number": "772-467-0961",
            "fax_number": "772-467-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814955",
            "telephone_number": "772-467-0961",
            "fax_number": "772-467-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS HEALTH PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GARTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-467-0961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.