Active NPI
Nakiesha Walton
- Driver
- Dekalb, IL
National Provider Identifier
1265033179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- W4356-3797-698
- Practice address
- 807 Ridge Dr # 520
Dekalb, IL 60115-1385 - Phone
- (815) 508-7131
- NPI assigned
- Nov 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | W4356-3797-698 | IL | Primary |
Addresses
Primary practice location
807 Ridge Dr # 520
Dekalb, IL 60115-1385
Mailing address
835 Edgebrook Dr Apt 115
Dekalb, IL 60115-1446
Phone (815) 508-7131
Other practice location 1
835 Edgebrook Dr Apt 115
Dekalb, IL 60115-1446
Phone (815) 508-7131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W4356-3797-698 | IL | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1265033179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 EDGEBROOK DR APT 115",
"city": "DEKALB",
"state": "IL",
"postal_code": "601151446",
"telephone_number": "815-508-7131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 RIDGE DR # 520",
"city": "DEKALB",
"state": "IL",
"postal_code": "601151385",
"telephone_number": "815-508-7131"
}
],
"practiceLocations": [
{
"address_1": "835 Edgebrook Dr Apt 115",
"address_purpose": "LOCATION",
"city": "Dekalb",
"state": "IL",
"postal_code": "601151446",
"country_code": "US",
"telephone_number": "815-508-7131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALTON",
"first_name": "NAKIESHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Driver",
"state": "IL",
"license": "W4356-3797-698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.