Active NPI
Gary D. Walters, NP
- Nurse Practitioner
- Bakersfield, CA
National Provider Identifier
1528259207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11913
- Practice address
- 1830 Flower St
Bakersfield, CA 93305-4144 - Phone
- (661) 872-3311
- Fax
- (661) 872-3366
- NPI assigned
- Aug 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 11913 | CA | |
| Nurse Practitioner | 363L00000X | 11913 | CA | Primary |
Addresses
Primary practice location
1830 Flower St
Bakersfield, CA 93305-4144
Mailing address
1830 Flower St
Bakersfield, CA 93305-4144
Phone (661) 872-3311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11913 | Other | CA | NP LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11913 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186444800000",
"number": "1528259207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 FLOWER ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933054144",
"telephone_number": "661-872-3311",
"fax_number": "661-872-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 FLOWER ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933054144",
"telephone_number": "661-872-3311",
"fax_number": "661-872-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "GARY",
"middle_name": "D.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-07",
"last_updated": "2007-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CA",
"license": "11913",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "11913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NP LICENSE",
"identifier": "11913",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.