Kristie Nicole Walton, APN

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26NJ00857600 Issued in NJ

Practice address

1075 Central Ave
Clark, NJ 07066-1116

Phone

(732) 574-1399

Fax

(732) 574-1433

NPI assigned

Nov 27, 2018

Last updated

Nov 27, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clark Dermatology LLC

  dba Metropolitan Dermatology

  • Dermatology Physician
  • Clark, NJ
  • NPI 1851562425

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Clark Dermatology, LLC

  dba Metropolitan Dermatology

  • Dermatology Physician
  • Staten Island, NY
  • NPI 1417316274
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1326518937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE STE 3",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082904",
            "telephone_number": "732-574-1399",
            "fax_number": "908-512-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 CENTRAL AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661116",
            "telephone_number": "732-574-1399",
            "fax_number": "732-574-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "KRISTIE",
        "middle_name": "NICOLE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ00857600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Rite Aid)
• Walgreen Co (Walgreens #18312)
• Kamesha Walkins, LCSW
• Walnut Medical Group LLC
• Victoria Yvonne Walter, PT, DPT
• Alexander L Wang, PHARMD
• We Cope Counseling and Consulting, LLC
• Patricia Louise Wehrle-Janowski
• Well Health Rehabilitation LLC
• David E Wexler, MD FACG AGAF

• Family Medicine Physician in Clark, NJ
• Providers in Clark, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.

Verify at the official NPI Registry.