Individual provider Active NPI

Kera Jessica Walter, DO

  • Family Medicine Physician
  • Florence, KY
National Provider Identifier
1689049652
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05073 Issued in KY
Practice address
8780 US 42
Florence, KY 41042-6936
Phone
(859) 384-8320
Fax
(859) 384-8338
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.00608546 CO
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 05073 KY Primary

Addresses

Primary practice location

8780 US 42
Florence, KY 41042-6936

Mailing address

237 William Howard Taft Rd
Cincinnati, OH 45219-2610
Phone (513) 351-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181012001153 CO Practitioner - Family Practice 2365794740 Reassigns benefits to 1 organization
I20210928002579 KY Practitioner - Family Practice 2365794740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christ Hospital Medical Associates, II LLCGroup PAC ID 7012197619, 24 clinicians

Practice addresses (Care Compare)

8780 US
Suite 42
Florence, KY 41042-6936
Phone (859) 384-8320

Hospital & facility affiliations

  • St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05073KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Christ Hospital Medical Associates II, LLC Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 10, 2018 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Sep 10, 2018 Accepting new patients

Locations

500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803

8780 US Highway 42
Florence, KY 41042
Phone (859) 384-2660

1955 Dixie Hwy
Ste D
Ft Wright, KY 41011
Phone (859) 341-5757

237 Wm Howard Taft Rd
Cincinnati, OH 45219
Phone (513) 351-9900

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1689049652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 WILLIAM HOWARD TAFT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192610",
            "telephone_number": "513-351-9900",
            "fax_number": "513-366-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8780 US 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410426936",
            "telephone_number": "859-384-8320",
            "fax_number": "859-384-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "KERA",
        "middle_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.00608546",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.