Individual provider Active NPI

Stephanie Marie Walters, NP-C

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1518454388
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN192018 Issued in GA
Practice address
303 Parkway Dr NE
Atlanta, GA 30312-1212
Phone
(404) 265-4000
NPI assigned
Apr 17, 2018
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN192018 GA Primary

Addresses

Primary practice location

303 Parkway Dr NE
Atlanta, GA 30312-1212

Mailing address

PO Box 1698
Evans, GA 30809-1698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20181126001027 GA Practitioner - Nurse Practitioner 7810241130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN192018GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2018 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

4550 Cobb Parkway North NW
Ste 101
Acworth, GA 30101
Phone (470) 956-0100

5655 Highway 9 N
Ste A
Alpharetta, GA 30004
Phone (770) 343-6364

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1518454388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1698",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308091698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKWAY DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121212",
            "telephone_number": "404-265-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN192018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.