NPIMap

Individual provider Active NPI

James Earl Walters III, FNP-C

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1528814423
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188282 Issued in VA
Practice address
351 Edwin Dr Ste 102
Virginia Beach, VA 23462-4559
Phone
(757) 499-5550
NPI assigned
Apr 30, 2024
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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 0024188282 VA Primary

Addresses

Primary practice location

351 Edwin Dr Ste 102
Virginia Beach, VA 23462-4559

Mailing address

3120 Edinburgh Dr
Virginia Beach, VA 23452-7006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240520001960 VA Practitioner - Nurse Practitioner 0840632048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

351 Edwin Dr
Suite 102
Virginia Beach, VA 23462-4559
Phone (804) 499-5550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jun 1, 2024 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 128
Newport News, VA 23606

351 Edwin Dr
Ste 102
Virginia Beach, VA 23462
Phone (757) 499-5550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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 12

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": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1528814423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 EDINBURGH DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 EDWIN DR STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624559",
            "telephone_number": "757-499-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JAMES",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.