Individual provider Active NPI

Kynyahta L Walters, APRN, FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1255810966
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.004144 Issued in IL
Practice address
1401 N Western Ave
Chicago, IL 60622-1735
Phone
(708) 292-7000
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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 277.004144 IL Primary

Addresses

Primary practice location

1401 N Western Ave
Chicago, IL 60622-1735

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (708) 292-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180910002456 IL Practitioner - Nurse Practitioner 7416207626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1401 Western Ave
Chicago Heights, IL 60411-3147
Phone (708) 292-7000

Hospital & facility affiliations

  • Premier Point Home Health, Inc Home health agency, Chicago, IL, CCN 148025
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277.004144ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Infectious Disease PC CurrentSince Aug 6, 2018 Accepting new patients
Oak Street Health Physicians Group, PC Family CurrentSince Apr 11, 2022 Accepting new patients

Locations

1401 N Western Ave
Chicago, IL 60622
Phone (708) 292-7000

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

1401 Western Ave
Chicago Heights, IL 60411
Phone (708) 292-7000

430 E 162nd St
South Holland, IL 60473
Phone (312) 504-5757

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1255810966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "708-292-7000",
            "fax_number": "708-887-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221735",
            "telephone_number": "708-292-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "KYNYAHTA",
        "middle_name": "L",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.004144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.