Active NPI
Dorthia S Walters, CFNP
- Nurse Practitioner
- Houlka, MS
National Provider Identifier
1306860697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R573388
- Practice address
- 106 Walker St
Houlka, MS 38850-9453 - Phone
- (662) 568-3316
- Fax
- (662) 568-3360
- NPI assigned
- Jul 27, 2006
- Last updated
- Jan 14, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R573388 | MS | Primary |
Addresses
Primary practice location
106 Walker St
Houlka, MS 38850-9453
Mailing address
PO Box 187
Houlka, MS 38850-0187
Phone (662) 568-3316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07770365 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Family Health Services, Inc. | Past | Accepting new patients | |
| Delta Physician Practices | Past | Accepting new patients | |
| Delta Medical Group | Nurse Practitioner | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba ACCESS Family Health - Houlka Clinic
- Community Health Clinic/Center
- Houlka, MS
- NPI 1457461527
-
- Family Nurse Practitioner
- Greenville, MS
- NPI 1598086639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1306860697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 187",
"city": "HOULKA",
"state": "MS",
"postal_code": "388500187",
"telephone_number": "662-568-3316",
"fax_number": "662-568-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 WALKER ST",
"city": "HOULKA",
"state": "MS",
"postal_code": "388509453",
"telephone_number": "662-568-3316",
"fax_number": "662-568-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "DORTHIA",
"middle_name": "S",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R573388",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07770365",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houlka, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.