Henry C Walters Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22859 Issued in NC

Practice address

1217 Davie Ave
Statesville, NC 28677-3511

Phone

(704) 372-2677

Fax

(704) 660-4625

NPI assigned

Jan 11, 2006

Last updated

Oct 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1780663567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-372-2677",
            "fax_number": "704-660-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-372-2677",
            "fax_number": "704-660-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "HENRY",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "22859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985531",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twilla Mitchell Walker, FNP
• Anita Wallak, RD, LDN
• Shawn Michael Walls, DO
• Ashley Walsh
• Patricia Louise Walter, RN, WHNP
• Yan Fei Wang, DO
• Robert J Ward, M.D.
• Lisa Rene Warlick, LCAS
• Brent Blair Warren, MD
• Shanee Wasson, LCMHC-A, LCAS-A

• Internal Medicine Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.