Individual provider Active NPI

Avion J Thomas-Walsh, FNP

  • Family Nurse Practitioner
  • Port Jervis, NY
National Provider Identifier
1235483082
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337645 Issued in NY
Practice address
158 Pike St
Port Jervis, NY 12771-1800
Phone
(845) 672-4420
Fax
(949) 655-5993
NPI assigned
Nov 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 F337645 NY Primary

Addresses

Primary practice location

158 Pike St
Port Jervis, NY 12771-1800

Mailing address

158 Pike St
Port Jervis, NY 12771-1800
Phone (845) 672-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201224000111 NY Practitioner - Nurse Practitioner 6901218569

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

158 Pike St
Port Jervis, NY 12771-1829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F337645NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Narrow Path Family Health NP PC Family CurrentSince Oct 23, 2020 Accepting new patients

Organizations & group practices 1

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": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1235483082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711800",
            "telephone_number": "845-672-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711800",
            "telephone_number": "845-672-4420",
            "fax_number": "949-655-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-WALSH",
        "first_name": "AVION",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.