Individual provider Active NPI

Stacey Walton, NP

  • Family Nurse Practitioner
  • Lowville, NY
National Provider Identifier
1457013401
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
348622 Issued in NY
Practice address
7785 N State St FL 3
Lowville, NY 13367-1297
Phone
(315) 376-5287
NPI assigned
Oct 7, 2021
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 348622 NY Primary

Addresses

Primary practice location

7785 N State St FL 3
Lowville, NY 13367-1297

Mailing address

2534 Millers Woods Rd
Boonville, NY 13309-5019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20211126000000 NY Practitioner - Nurse Practitioner 0446640924 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lewis CountyGroup PAC ID 2668463779, shared by 14 NPIs, 39 clinicians

Practice addresses (Care Compare)

3926 State Route 12
Lyons Falls, NY 13368-1919
Phone (315) 348-8407

7785 N State St
FL 3
Lowville, NY 13367-1229
Phone (315) 376-5287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
348622NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County General Hospital CurrentSince Dec 1, 2021 Accepting new patients
Lewis County CurrentSince Dec 1, 2021 Accepting new patients
Lewis County General Hospital CurrentSince Dec 1, 2021 Accepting new patients
Lewis County General Hospital Current Accepting new patients
Lewis County General Hospital CurrentSince Dec 1, 2021 Accepting new patients
Lewis County Past Accepting new patients

Locations

7785 N State St
Lowville, NY 13367
Phone (315) 376-5102

7785 N State St
#3
Lowville, NY 13367

7785 N State St
Fl 3
Lowville, NY 13367
Phone (315) 376-5287

3926 State Route 12
Lyons Falls, NY 13368
Phone (315) 348-8407

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1457013401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 MILLERS WOODS RD",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133095019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7785 N STATE ST FL 3",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671297",
            "telephone_number": "315-376-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "STACEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowville, NY

Sources for this page

Verify at the official NPI Registry.