NPIMap

Individual provider Active NPI

Olivia Ann Walder, APRN

  • Family Nurse Practitioner
  • Onarga, IL
National Provider Identifier
1407543838
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209027194 Issued in IL
Practice address
912 W Seminary Ave
Onarga, IL 60955-1401
Phone
(815) 268-4840
Fax
(815) 268-4845
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041454193 IL
Family Nurse Practitioner 363LF0000X 209027194 IL Primary

Addresses

Primary practice location

912 W Seminary Ave
Onarga, IL 60955-1401

Mailing address

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516002668 IL Practitioner - Nurse Practitioner 6406212547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gibson Community Hospital AssociationGroup PAC ID 5092703124, 159 clinicians

Practice addresses (Care Compare)

912 W Seminary Ave
Onarga, IL 60955-1401
Phone (815) 268-4840

Hospital & facility affiliations

  • Gibson Community Hospital Hospital, Gibson City, IL, CCN 141317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041454193ILMDRegistered Nurse
209027194ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince Dec 12, 2023 Accepting new patients
Smart Health and Wellness, PLLC CurrentSince May 1, 2023 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Dec 12, 2023 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

735 N Logan Ave
Danville, IL 61832
Phone (217) 280-8502

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

912 W Seminary Ave
Onarga, IL 60955
Phone (815) 268-4840

227 N Market St
Paxton, IL 60957
Phone (217) 379-4864

Interoperability endpoints

  • Direct secure messaging: olivia.walder.p6@direct.gapho.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1407543838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W SEMINARY AVE",
            "city": "ONARGA",
            "state": "IL",
            "postal_code": "609551401",
            "telephone_number": "815-268-4840",
            "fax_number": "815-268-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDER",
        "first_name": "OLIVIA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041454193",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209027194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onarga, IL

Sources for this page

Verify at the official NPI Registry.