Active NPI
Bailey J Walters
- Social Worker
- Minot, ND
National Provider Identifier
1629411152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 5091
- Practice address
- 1425 21St Ave NW
Suite a
Minot, ND 58703-0816 - Phone
- (701) 839-8887
- Fax
- (701) 839-8990
- NPI assigned
- Apr 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 5091 | ND | Primary |
Addresses
Primary practice location
1425 21St Ave NW
Suite a
Minot, ND 58703-0816
Mailing address
1425 21St Ave NW
Suite a
Minot, ND 58703-0816
Phone (701) 839-8887
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5091 | ND | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1629411152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 21ST AVE NW",
"address_2": "SUITE A",
"city": "MINOT",
"state": "ND",
"postal_code": "587030816",
"telephone_number": "701-839-8887",
"fax_number": "701-839-8990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 21ST AVE NW",
"address_2": "SUITE A",
"city": "MINOT",
"state": "ND",
"postal_code": "587030816",
"telephone_number": "701-839-8887",
"fax_number": "701-839-8990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "BAILEY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-15",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ND",
"license": "5091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.