Alycia Ann Walty, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

42455 Issued in KY

Practice address

211 US Highway 421 S
MC Kee, KY 40447-9425

Phone

(606) 287-7104

Fax

(606) 287-4409

NPI assigned

Sep 8, 2008

Last updated

Jul 8, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alycia.walty@slpg.direct-sluhn.org

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.

• Star Community Health, Inc

  • General Practice Physician
  • Bethlehem, PA
  • NPI 1033686159
  Medicare reassignment NPD
• Star Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Bethlehem, PA
  • NPI 1942832720
  NPD

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1275781817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 US HIGHWAY 421 S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404479425",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTY",
        "first_name": "ALYCIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD451752",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08433100",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "42455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100087740",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thompson Drug McKee, Inc (Thompson Drug Mckee)
• Tracie Lynn Vanwinkle, IECE
• Jami Vaughn
• Penelope Waite, MSN, APRN, FNP-C
• Walgreen Co (Walgreens #17796)
• Marcia White, PHARMD
• Bradley Williams, M.D.
• Tiffany Renee Williamson, LCSW

• Pediatrics Physician in McKee, KY
• Providers in McKee, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.