Kristen Elizabeth Walsh, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11742 Issued in NC

Practice address

509 Olde Waterford Way
Ste 102
Leland, NC 28451-4125

Phone

(910) 641-8650

NPI assigned

May 10, 2011

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Regional Health NetworkGroup PAC ID 6608924931, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Columbus Regional Healthcare System Hospital, Whiteville, NC, CCN 340068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crhs@crhn.cernerdirect.com
• Direct secure messaging: kwalsh@crhn.cernerdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbus Regional Health Network

  dba Advanced Family Care

  • Hospitalist Physician
  • Whiteville, NC
  • NPI 1508001009
  Medicare reassignment Care Compare group
• Columbus Regional Health Network

  dba Columbus Regional Urgent Care

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1134509912
  NPD
• Columbus Regional Health Network

  dba Advanced Orthopedics

  • Orthopaedic Surgery Physician
  • Whiteville, NC
  • NPI 1790224962
  NPD
• Columbus Regional Health Network

  dba Advanced Primary Care

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbus Regional Healthcare System

  dba South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
  • NPI 1376537555
  Care Compare affiliation

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1134411184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLDE WATERFORD WAY",
            "address_2": "STE 102",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514125",
            "telephone_number": "910-641-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Whiteville",
            "state": "NC",
            "postal_code": "284723704",
            "country_code": "US",
            "telephone_number": "910-641-8625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2024-07-15",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crhs@crhn.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "Columbus Regional Healthcare System, Inc.",
            "address_1": "509 Olde Waterford Way",
            "address_2": "Ste 102",
            "city": "Leland",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284514125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-4273)
• Wal-Mart Stores East, L.P. (Vision Center 30-4273)
• Walgreen Co (Walgreens #01956)
• Walgreen Co (Walgreens 11352)
• Walgreen Co (Rite Aid)
• Ryan Xavier Walsh, DPT
• Walter B. Futch, Jr. DDS PA
• Bradley John Walter, D.C.
• Tracey Walton
• Waterford Wellness, PA

• Physician Assistant in Leland, NC
• Providers in Leland, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.