Active NPI
Susan Walter
- Specialist
- Abingdon, MD
National Provider Identifier
1194273409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 02861
- Practice address
- 101 Walter Ward Blvd
Abingdon, MD 21009-1210 - Phone
- (443) 409-0051
- NPI assigned
- Sep 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 02861 | MD | Primary |
Addresses
Primary practice location
101 Walter Ward Blvd
Abingdon, MD 21009-1210
Mailing address
101 Walter Ward Blvd
Abingdon, MD 21009-1210
Phone (443) 409-0051
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02861 | MD | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1194273409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WALTER WARD BLVD",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210091210",
"telephone_number": "443-409-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WALTER WARD BLVD",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210091210",
"telephone_number": "443-409-0051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-15",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "02861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, MD
- Wal-Mart Stores East, LP (Vision Center 30-2009)
- Walgreen Co (Walgreens #07357)
- Walgreen Co. (Walgreens #7357)
- Charles Walker, PHARMD
- Megan Katherine Walker, PA-C
- Wegmans Food Markets, Inc. (Wegmans Pharmacy #053)
- Benjamin Martin Welch, DPT
- Bernadette Mary Wendel, LCSW-C
- Ashlyn Whalen
- Amber Rae Whitaker, LCSW-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.