Jenny Violet Walter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005362 Issued in WA

Practice address

2616 Kwina Rd
Bellingham, WA 98226-9291

Phone

(360) 380-6945

Fax

(360) 384-2350

NPI assigned

Jan 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwalter348927@direct.ochin.org

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.

• Lummi Indian Business Council

  • Clinic/Center
  • Bellingham, WA
  • NPI 1669592374
  Medicare reassignment Care Compare group NPD
• Lummi Indian Business Council

  • Recovery Care Clinic/Center
  • Bellingham, WA
  • NPI 1407979289
  NPD (past)

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1669658993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269291",
            "telephone_number": "360-380-6945",
            "fax_number": "360-384-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269291",
            "telephone_number": "360-380-6945",
            "fax_number": "360-384-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JENNY",
        "middle_name": "VIOLET",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "10005362",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8505596",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Kyrin Walsh
• Patrick Glen Walsh, RN
• Walter & Chen, PS
• Charles Walter, DDS
• Taylor Lauren Walter, LMT
• Danielle Walters, RN
• Donald Thomas Walters, DDS
• Jeremy Charles Walters, M.S., MHP
• Lawrence Cooper Walters, MD

• Physician Assistant in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.