Mary Jane Walters, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

057091 Issued in NC

Practice address

1000 Blythe Blvd
Carolina Medical Center
Charlotte, NC 28203-5812

Phone

(704) 355-8983

Fax

(704) 355-8994

NPI assigned

Jun 9, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carolinas Medical Center

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1619041514

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Mercy Hospital, Inc.

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1801961875

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Mooresville Hospital Management Associates LLC

  dba Lake Norman Regional Medical Center

  • General Acute Care Hospital
  • Mooresville, NC
  • NPI 1073568754
  NPD (past)
• Mooresville Hospital Management Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Mooresville, NC
  • NPI 1548399827

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1801837919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32861",
            "address_2": "ANESTHESIA SERVICES, 5TH FLOOR SURGERY TOWER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322861",
            "telephone_number": "704-355-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "address_2": "CAROLINA MEDICAL CENTER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-8983",
            "fax_number": "704-355-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "057091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050782",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN789",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel R. Walters, DC
• Dashaun Walters
• Kelci Walters, O.D.
• Linda Walters, L.C.S.W.
• Madison Hanna Walters
• Michael Richard Walters, PT
• Rasheka Walters, PMHNP-BC
• Julius Byron Walthall Jr., M.D.
• Kayla Walthall
• Walton S. Peery,DDS PA

• Certified Registered Nurse Anesthetist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.