Individual provider Active NPI

Hayley Walters

  • Psychiatric/Mental Health Nurse Practitioner
  • Homer, AK
National Provider Identifier
1225414394
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024103336 Issued in NM
Practice address
818 Smoky Bay Way Ste 414
Homer, AK 99603-7653
Phone
(907) 531-2800
NPI assigned
Jul 30, 2015
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024103336 NM Primary
Advanced Practice Midwife 367A00000X 703 NM

Addresses

Primary practice location

818 Smoky Bay Way Ste 414
Homer, AK 99603-7653

Mailing address

818 Smoky Bay Way Ste 414
Homer, AK 99603-7653

Other practice location 1

4300 Bartlett St
Homer, AK 99603-7000
Phone (907) 226-5630

Other identifiers 1

IdentifierTypeStateIssuer
23905841MedicaidNM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250708003472 AK Practitioner - Nurse Practitioner 9830499789 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
703NMMDForensic Psychologist
2024103336NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Peninsula Hospital, Inc CurrentSince Apr 30, 2025 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Apr 1, 2025 Accepting new patients
South Peninsula Hospital, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Center for Prenatal Development Past Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Locations

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

Interoperability endpoints

  • Direct secure messaging: hayley.walters.1@14977.direct.athenahealth.com
  • FHIR API: https://fhir-usa.unify.chbase.com/org/sphosp-0c203fcf

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1225414394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 SMOKY BAY WAY STE 414",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SMOKY BAY WAY STE 414",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037653",
            "telephone_number": "907-531-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Bartlett St",
            "address_purpose": "LOCATION",
            "city": "Homer",
            "state": "AK",
            "postal_code": "996037000",
            "country_code": "US",
            "telephone_number": "907-226-5630",
            "fax_number": "888-273-7282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "HAYLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "2024103336",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23905841",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

Verify at the official NPI Registry.