Individual provider Active NPI

Alice Cheatham Parker Walter, NP

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1629693460
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25486 Issued in SC
Practice address
649 Wampler Dr
Charleston, SC 29412-9157
Phone
(843) 754-6919
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 284480 NC
Nurse Practitioner 363L00000X 5013277 NC
Nurse Practitioner 363L00000X 25486 SC Primary

Addresses

Primary practice location

649 Wampler Dr
Charleston, SC 29412-9157

Mailing address

649 Wampler Dr
Charleston, SC 29412-9157

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220224002530 SC Practitioner - Nurse Practitioner 3476963513 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284480NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Onsite Medical Solutions SC Coastal LLC CurrentSince Oct 23, 2024 Accepting new patients
Advanced Wound Care Specialist LLC CurrentSince Oct 6, 2024 Accepting new patients
Onsite Medical Solutions SC Upstate LLC CurrentSince Nov 5, 2024 Accepting new patients
Onsite Healthcare and Wellness LLC Nurse Practitioner CurrentSince Apr 30, 2024 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients

Locations

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (256) 497-0032

105 Franklin Square Way
#A
Easley, SC 29642
Phone (864) 442-4019

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1629693460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 WAMPLER DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 WAMPLER DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129157",
            "telephone_number": "843-754-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ALICE",
        "middle_name": "CHEATHAM PARKER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "284480",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013277",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "25486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "4055 Valley View Ln Ste 700",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752445045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.