Individual provider Active NPI

Julianne Walters, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newtown Square, PA
National Provider Identifier
1770179343
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP022563 Issued in PA
Practice address
3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone
(484) 337-1530
Fax
(484) 337-1412
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP022563 PA Primary

Addresses

Primary practice location

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20201231000750 PA Practitioner - Nurse Practitioner 3173936549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Delaware County Professional Services, IncGroup PAC ID 2668436692, 276 clinicians

Practice addresses (Care Compare)

3800 Sierra Cir
Suite 210
Center Valley, PA 18034-8476
Phone (610) 892-3800

600 Evergreen Dr
Suite 103
Glen Mills, PA 19342-1053
Phone (610) 892-3800

780 E Market St
West Chester, PA 19382-4882
Phone (610) 892-3800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Nurse Practitioner CurrentSince Feb 1, 2021 Accepting new patients
Advanced Practice Psychiatric, LLC Psychiatric/Mental Health Current Accepting new patients
Delaware County Professional Services, Inc CurrentSince Jul 5, 2023 Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

3800 Sierra Cir
Ste 210
Center Valley, PA 18034
Phone (855) 995-5384

600 Evergreen Dr
Ste 103
Glen Mills, PA 19342
Phone (267) 857-4864

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

780 E Market St
West Chester, PA 19382
Phone (425) 908-0237

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.juliannewalters@141748.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1770179343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1530",
            "fax_number": "484-337-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1530",
            "fax_number": "484-337-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JULIANNE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP022563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

Verify at the official NPI Registry.