Individual provider Active NPI

Benita Walton-Moss, C.R.N.P., D.N.SC.

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124060553
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R66787 Issued in MD
Practice address
4940 Eastern Ave
Baltimore, MD 21224-2735
Phone
(410) 550-0519
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R66787 MD Primary

Addresses

Primary practice location

4940 Eastern Ave
Baltimore, MD 21224-2735

Mailing address

PO Box 64474
Baltimore, MD 21264-4474

Other names 1

  • Benita Walton Other name

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2018 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R66787MDMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124060553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64474",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON-MOSS",
        "first_name": "BENITA",
        "credential": "C.R.N.P., D.N.SC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R66787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENITA",
            "last_name": "WALTON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.