Active NPI
Natalie Walters
- Physician Assistant
- Saint Charles, IL
National Provider Identifier
1275406266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601013456
- Practice address
- 4N549 Hidden Oaks Rd
Saint Charles, IL 60175-8512 - Phone
- (630) 877-2799
- NPI assigned
- Sep 25, 2025
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601013456 | MI | Primary |
Addresses
Primary practice location
4N549 Hidden Oaks Rd
Saint Charles, IL 60175-8512
Mailing address
4N549 Hidden Oaks Rd
Saint Charles, IL 60175-8512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3350 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-4570
6501 Yale St
Apt 415
Westland, MI 48185-2123
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601013456 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1275406266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4N549 HIDDEN OAKS RD",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601758512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4N549 HIDDEN OAKS RD",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601758512",
"telephone_number": "630-877-2799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "NATALIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-25",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601013456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.