Individual provider Active NPI

John David Walsh, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Reno, NV
National Provider Identifier
1790169738
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP128566 Issued in TX
Practice address
515 Court St
Reno, NV 89501-1710
Phone
(775) 410-0189
Fax
(775) 339-0105
NPI assigned
Jul 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 864972 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP128566 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11025468 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 101.0136501 VT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.27723 SC

Addresses

Primary practice location

515 Court St
Reno, NV 89501-1710

Mailing address

11 Colonel Hazzard Rd
Okatie, SC 29909-7003
Phone (512) 851-9260

Other practice location 1

9850C Emmett F Lowry Expy Ste C103
Texas City, TX 77591-2122
Phone (409) 938-2234

Other practice location 2

13830 Sawyer Ranch Rd Ste 301
Dripping Springs, TX 78620-5514
Phone (512) 853-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151019000741 TX Practitioner - Nurse Practitioner 7810206620 Reassigns benefits to 10 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11025468FLMDPsychiatric/Mental Health Nurse Practitioner
864972NVMDPsychiatric/Mental Health Nurse Practitioner
APN.27723SCMDPsychiatric/Mental Health Nurse Practitioner
101.0136501VTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Mental Health and Mental Retardation Center CurrentSince Oct 1, 2020 Accepting new patients
Border Region MH Mr Community Center CurrentSince Jan 22, 2021 Accepting new patients
Texana Center CurrentSince Jan 11, 2022 Accepting new patients
Coastal Health & Wellness CurrentSince Feb 9, 2023 Accepting new patients
Coastal Health & Wellness Current Accepting new patients
Helen Farabee Centers CurrentSince Sep 15, 2021 Accepting new patients
Camino Real Community MHMR Center CurrentSince Oct 12, 2019 Accepting new patients
Bluebonnet Trails Community MHMR Center CurrentSince Aug 19, 2020 Accepting new patients
Collin County Mental Health Mental Retardation Center Psychiatric/Mental Health CurrentSince Jun 23, 2020 Accepting new patients
Burke Center CurrentSince Mar 10, 2020 Accepting new patients
Bluebonnet Trails Community MHMR Center CurrentSince Aug 19, 2020 Accepting new patients
Anderson Cherokee Community Enrichment Services Psychiatric/Mental Health Current Accepting new patients
The Gulf Coast Center CurrentSince Oct 8, 2023 Accepting new patients
Sagebrush Psychiatry, PLLC Psychiatric/Mental Health PastSince Apr 9, 2024 Accepting new patients
Dripping Springs Healthcare PLLC PastSince Feb 1, 2020 Accepting new patients

Locations

101 Tigner St
Angleton, TX 77515
Phone (800) 710-4322

408 Mulberry St
Brownwood, TX 76801
Phone (325) 646-9574

123 Rosenberg St
Ste 4
Galveston, TX 77550

4700 Broadway St
Ste 100
Galveston, TX 77551
Phone (409) 763-7204

1011 College Ave
Jacksonville, TX 75766
Phone (903) 541-2577

1749 E State Highway 97
Jourdanton, TX 78026
Phone (830) 767-2320

4444 W Main St
League City, TX 77573

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

19965 FM 3175
Lytle, TX 78052
Phone (210) 357-0300

1515 Heritage Dr
Ste 105
McKinney, TX 75069
Phone (972) 562-0331

7308 Alma Dr
Plano, TX 75025
Phone (972) 422-5939

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

1009 N Georgetown St
Round Rock, TX 78664
Phone (512) 244-8374

7510 FM 1765
Texas City, TX 77591
Phone (409) 935-6083

9850 Emmett F Lowry Expy
Ste C103
Texas City, TX 77591
Phone (409) 938-2234

500 Broad St
Wichita Falls, TX 76301
Phone (940) 397-3300

1000 Brook Ave
Wichita Falls, TX 76301
Phone (940) 397-3100

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1790169738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 COLONEL HAZZARD RD",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299097003",
            "telephone_number": "512-851-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 COURT ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895011710",
            "telephone_number": "775-410-0189",
            "fax_number": "775-339-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9850C Emmett F Lowry Expy Ste C103",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "775912122",
            "country_code": "US",
            "telephone_number": "409-938-2234",
            "fax_number": "409-938-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13830 Sawyer Ranch Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Dripping Springs",
            "state": "TX",
            "postal_code": "786205514",
            "country_code": "US",
            "telephone_number": "512-853-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-18",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "864972",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP128566",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11025468",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0136501",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "APN.27723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.