Individual provider Active NPI

Jariel Walton

  • Driver
  • Suffolk, VA
National Provider Identifier
1700356706
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
T60647080 Issued in VA
Practice address
2007 Jehu St
Suffolk, VA 23435-3539
Phone
(757) 477-2680
NPI assigned
Dec 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X T60647080 VA Primary

Addresses

Primary practice location

2007 Jehu St
Suffolk, VA 23435-3539

Mailing address

2007 Jehu St
Suffolk, VA 23435-3539
Phone (757) 477-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T60647080VAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Express Transportation, LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1700356706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 JEHU ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353539",
            "telephone_number": "757-477-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 JEHU ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353539",
            "telephone_number": "757-477-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "JARIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "VA",
            "license": "T60647080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.