Active NPI
Sharon D Waltz, PSY.D.
- Clinical Psychologist
- Pelham, AL
National Provider Identifier
1295025997
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1228
- Practice address
- 1365 Caliston Way
Pelham, AL 35124 - Phone
- (330) 966-0922
- NPI assigned
- Apr 14, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1228 | AL | Primary |
| Psychologist | 103T00000X | |||
| Clinical Neuropsychologist | 103G00000X | AL-1228 | AL |
Addresses
Primary practice location
1365 Caliston Way
Pelham, AL 35124
Mailing address
1365 Caliston Way
Pelham, AL 35124
Phone (205) 664-3271
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL-1228 | AL | MD | Clinical Neuropsychologist |
| 1228 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1295025997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 CALISTON WAY",
"city": "PELHAM",
"state": "AL",
"postal_code": "35124",
"telephone_number": "205-664-3271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 CALISTON WAY",
"city": "PELHAM",
"state": "AL",
"postal_code": "35124",
"telephone_number": "330-966-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTZ",
"first_name": "SHARON",
"middle_name": "D",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-14",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1228",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AL",
"license": "AL-1228",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pelham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.