Frederick Charles Walters, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00040201 Issued in WA

Practice address

1298 Grow Ave NW
Bainbridge Island, WA 98110

Phone

(206) 780-5437

Fax

(206) 780-5438

NPI assigned

Jan 8, 2007

Last updated

Jun 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bainbridge Pediatrics, PLLC

  • Pediatric Adolescent Medicine Physician
  • Bainbridge Island, WA
  • NPI 1851424931
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1659429793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1298 GROW AVE NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-780-5437",
            "fax_number": "206-780-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1298 GROW AVE NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-780-5437",
            "fax_number": "206-780-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "FREDERICK",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00040201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039577",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US7740466",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8369928",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "7675WA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• W Bradford Hepworth DDS MD Ms PC
• Ilana Waite, PSYD
• Walgreen Co (Walgreens #15673)
• Stephen Anderson Walker
• Beverly Beckwith Walsh, LCSW-C; LICSW; PH.D.
• Diana Wang, DC
• Linda Denise Ward, PT
• Linda Shipley Warren, MD
• Heidi Anne Washenberger, P.T.
• Washington CVS Pharmacy LLC (CVS Pharmacy #11670)

• Pediatrics Physician in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.