Individual provider Active NPI

Jessica Walters, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1265932685
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
136213 Issued in AL
Practice address
4800 Whitesport Cir SW Ste 1
Huntsville, AL 35801-6443
Phone
(256) 327-0888
Fax
(256) 327-0897
NPI assigned
Feb 13, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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 136213 AL Primary

Addresses

Primary practice location

4800 Whitesport Cir SW Ste 1
Huntsville, AL 35801-6443

Mailing address

4800 Whitesport Cir SW Ste 1
Huntsville, AL 35801-6443
Phone (256) 327-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180629002208 AL Practitioner - Nurse Practitioner 9739435918 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

201 Whitesport Dr SW
Huntsville, AL 35801-6449
Phone 2568815353117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136213ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose Throat Head & Neck Surgery of Huntsville, P.C. CurrentSince Apr 16, 2024 Accepting new patients

Locations

201 Whitesport Dr SW
Huntsville, AL 35801
Phone (256) 693-6863

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.

Hospital & facility affiliations 1

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1265932685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 WHITESPORT CIR SW STE 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016443",
            "telephone_number": "256-327-0888",
            "fax_number": "256-327-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 WHITESPORT CIR SW STE 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016443",
            "telephone_number": "256-327-0888",
            "fax_number": "256-327-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JESSICA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "136213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.