NPIMap

Individual provider Active NPI

Regina Ann Walters, APRN, FNP- C

  • Family Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1215575816
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26789 Issued in TN
Practice address
1609 Rosewood Dr
Columbia, TN 38401-6420
Phone
(931) 388-8802
Fax
(931) 490-2292
NPI assigned
Dec 13, 2019
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26789 TN Primary

Addresses

Primary practice location

1609 Rosewood Dr
Columbia, TN 38401-6420

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL eClinicalworks

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200206001461 TN Practitioner - Nurse Practitioner 3577999754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northside Medical Professionals, P.C.Group PAC ID 8224224357, 20 clinicians

Practice addresses (Care Compare)

1605 Nashville Hwy
Suite 200
Columbia, TN 38401-2071
Phone (931) 540-4210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26789TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC CurrentSince Nov 24, 2019 Accepting new patients
Northside Medical Professionals, P.C. Family CurrentSince Jun 3, 2023 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Nov 24, 2019 Accepting new patients

Locations

1605 Nashville Hwy
Ste 200
Columbia, TN 38401
Phone (931) 540-4210

1609 Rosewood Dr
Columbia, TN 38401
Phone (615) 472-1855

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

1414 W College St
Pulaski, TN 38478
Phone (931) 363-3004

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1215575816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 ROSEWOOD DR",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016420",
            "telephone_number": "931-388-8802",
            "fax_number": "931-490-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "REGINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP- C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eClinicalworks",
            "affiliation": "N",
            "address_1": "1040 N James Campbell Blvd",
            "city": "Columbia",
            "state": "TN",
            "country_code": "US",
            "postal_code": "38401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.