Jacci Gayle Walden, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L4162 Issued in TX

Practice address

3504 Corinth Parkway
Suite 150
Corinth, TX 76208

Phone

(940) 498-4445

Fax

(940) 270-5002

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Denton County Health Department

  • Public Health or Welfare Agency
  • Denton, TX
  • NPI 1124136932
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1275645145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 CORINTH PARKWAY",
            "address_2": "SUITE 150",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "76208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 CORINTH PARKWAY",
            "address_2": "SUITE 150",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "76208",
            "telephone_number": "940-498-4445",
            "fax_number": "940-270-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "JACCI",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Verida Health Group LLC
• Fernando A Vignolo, D.D.S., M.S.
• Erin M Skrabanek Vincent, LAT
• Lisa Waid-McKenna, PHD, LPC-S
• Walden Family Medicine, PA
• Walgreen Co
• Sarah B Weitzul, MD
• Wilmann Management, LLC
• Megan Wilson, RN
• Deborah Casey Winder, LAT

• Family Medicine Physician in Corinth, TX
• Providers in Corinth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.