John T Walters, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

142182 Issued in AK

Practice address

1001 Noble St
Fairbanks, AK 99701-4922

Phone

(907) 458-2682

Fax

(907) 458-2628

NPI assigned

Sep 30, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score

92.86 of 100Reported as group

Quality

94.88

Promoting interoperability

100

Improvement activities

40

Cost

79.39

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.walters@direct.tananavalley.nextgenshare.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.

• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922559558
  Medicare reassignment Care Compare group NPD
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1073081485
  NPD
• Emergency Medicine Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fairbanks, AK
  • NPI 1275529109
  NPD (past)
• Guardian Flight Inc

  dba Canyon Clinic

  • Rural Health Clinic/Center
  • Denali, AK
  • NPI 1477726644
  NPD (past)
• Raymond E. Andreassen

  dba Family Medical Center

  • Family Medicine Physician
  • Delta Junction, AK
  • NPI 1366640070
  NPD (past)

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1215924659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014922",
            "telephone_number": "907-459-3500",
            "fax_number": "907-458-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014922",
            "telephone_number": "907-458-2682",
            "fax_number": "907-458-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "142182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDA0001",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Walling, PHYSICAL THERAPIST
• Laura Wallis-John, RN
• Jasmine M Wallis
• Walmart Inc. (Walmart Pharmacy 10-2722)
• Faith M Walsh, RNC
• Laurie J Walton, LMT
• Nevada Rae Walton, LCSW
• Thomas Walton
• Bonnie Wanner Owen
• Andrew James Wappett, D.M.D.

• Medical Physician Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.