Walton Francis Reddish, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R077177 Issued in MD

Practice address

1675 Woodbrooke Drive
Salisbury, MD 21804

Phone

(410) 749-4154

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, MD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Physician Network, Inc.Group PAC ID 7315901253, 115 clinicians

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Beebe Medical Center Hospital, Lewes, DE, CCN 080007
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735

  DE

  Medicare reassignment Care Compare group NPD
• Tidalhealth Physician Network, Inc.

  • Family Medicine Physician
  • Seaford, DE
  • NPI 1467534636
  Medicare reassignment Care Compare group NPD
• Peninsula Orthopaedic Associates, P.a.

  • Orthopaedic Surgery Physician
  • Salisbury, MD
  • NPI 1326114141
  NPD (past)
• Tidalhealth Specialty Care, LLC

  • Adult Mental Health Clinic/Center
  • Salisbury, MD
  • NPI 1962027094
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation
• Beebe Medical Center, Inc.

  • General Acute Care Hospital
  • Lewes, DE
  • NPI 1821196486
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1669548574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2415",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218022415",
            "telephone_number": "410-749-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WOODBROOKE DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-749-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDISH",
        "first_name": "WALTON",
        "middle_name": "FRANCIS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R077177",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J. Raygor, LCSW-C
• Ashly Rayne, LCSW-C
• Robert Wayne Realini, LGPC
• Krista Beth Records, PTA
• Richard Mann Reddish, D.D.S.
• Sahithi Reddy, MD
• Teja Nagaradona Reddy, MD, MPH
• Brandon Christopher Redmond, PAC
• George David Reeder, MD
• Reenvision Counseling & Reiki Healing, LLC

• Nurse Practitioner in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.