Individual provider Active NPI

Kelci Walters, O.D.

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1518433796
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2594 Issued in NC
Practice address
1823 E Arbors Dr Ste 325
Charlotte, NC 28262-2800
Phone
(704) 971-5000
Fax
(704) 971-5003
NPI assigned
Oct 16, 2018
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2594 NC Primary

Addresses

Primary practice location

1823 E Arbors Dr Ste 325
Charlotte, NC 28262-2800

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190207000186 MD Practitioner - Optometry 9436497005 Reassigns benefits to 2 organizations
I20210223002288 NC Practitioner - Optometry 9436497005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1823 E Arbors Dr
Suite 325
Charlotte, NC 28262-2662
Phone (704) 971-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2594NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Canton Crossing Optometry, LLC Optometrist CurrentSince Dec 25, 2018 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Dec 25, 2018 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Dec 25, 2018 Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

3715 Boston St
Baltimore, MD 21224
Phone (443) 839-0335

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

6455 Dobbin Rd
Ste 47
Columbia, MD 21045
Phone (443) 542-5999

1 Newport Dr
Ste J
Forest Hill, MD 21050
Phone (410) 838-3200

17301 Valley Mall Rd
Hagerstown, MD 21740
Phone (240) 850-2002

1809 Reisterstown Rd
Pikesville, MD 21208
Phone (410) 484-6348

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

1823 E Arbors Dr
Ste 325
Charlotte, NC 28262
Phone (704) 971-5000

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

7808 S Tryon St
Ste D
Charlotte, NC 28273
Phone (704) 522-8000

1729 Davie Ave
Statesville, NC 28677
Phone (704) 873-0524

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1518433796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 E ARBORS DR STE 325",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622800",
            "telephone_number": "704-971-5000",
            "fax_number": "704-971-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "KELCI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.