Individual provider Active NPI

Sandra Walters

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1689207516
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014369 Issued in KY
Practice address
1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone
(304) 399-6727
Fax
(304) 399-1507
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014369 KY Primary

Addresses

Primary practice location

1340 Hal Greer Blvd
Huntington, WV 25701-3804

Mailing address

1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 399-6727

Other identifiers 3

IdentifierTypeStateIssuer
0392078MedicaidOH
1689207516MedicaidWV
7100652340MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sandra.walters@direct.chhi.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 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

Enrollment IDStateProvider typePAC IDDetails
I20200406000703 WV Practitioner - Nurse Practitioner 3870922743 Reassigns benefits to 2 organizations
I20230726001573 OH Practitioner - Nurse Practitioner 3870922743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice of Huntington, Inc.Group PAC ID 3870572860, shared by 4 NPIs, 5 clinicians

Practice addresses (Care Compare)

1101 6TH Ave
Huntington, WV 25701-2345
Phone (304) 529-4217

48 Private Dr
Suite 339
South Point, OH 45680-8919
Phone (304) 894-0013

Hospital & facility affiliations

  • Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055
  • Rivers Health Hospital, Point Pleasant, WV, CCN 510012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3014369KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Huntington, Inc CurrentSince Jul 1, 2023 Accepting new patients
Cabell Huntington Hospital Inc CurrentSince Apr 6, 2020 Accepting new patients
Cabell Huntington Hospital Inc Current Accepting new patients
Hospice of Huntington, Inc CurrentSince Jul 1, 2023 Accepting new patients
Cabell Huntington Hospital Inc Family CurrentSince Apr 6, 2020 Accepting new patients

Locations

48 Private Drive 339
South Point, OH 45680
Phone (304) 894-0013

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

1101 6th Ave
Huntington, WV 25701
Phone (304) 522-2928

8 Stonecrest Dr
Huntington, WV 25701
Phone (304) 399-0225

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.

Hospital & facility affiliations 2

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": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1689207516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-399-6727",
            "fax_number": "304-399-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013804",
            "telephone_number": "304-399-6727",
            "fax_number": "304-399-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0392078",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689207516",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100652340",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandra.walters@direct.chhi.org",
            "affiliation": "N",
            "address_1": "1340 Hal Greer Blvd",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.