NPIMap

Individual provider Active NPI

Laura Marie Walters, MD

  • Family Medicine Physician
  • Kodiak, AK
National Provider Identifier
1831162825
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4067 Issued in AK
Practice address
1911 E Rezanof Dr
Kodiak, AK 99615-6602
Phone
(907) 481-5000
Fax
(907) 481-5030
NPI assigned
Feb 9, 2006
Last updated
Dec 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4067 AK Primary

Addresses

Primary practice location

1911 E Rezanof Dr
Kodiak, AK 99615-6602

Mailing address

1911 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 481-5000

Other identifiers 2

IdentifierTypeStateIssuer
920088665OtherCLINIC TAX ID
MD4067MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100326001001 AK Practitioner - Family Practice 8921198938 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Kodiak Island Health Care FoundationGroup PAC ID 8022922509, 15 clinicians
Providence Health and Services WashingtonGroup PAC ID 5799675120, shared by 3 NPIs, 32 clinicians

Practice addresses (Care Compare)

1911 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 481-5000

1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 486-3281

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.58 of 100Reported as group
Quality
74.05
Improvement activities
40
Cost
56.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Current Accepting new patients
Kodiak Island Health Care Foundation CurrentSince Nov 11, 2017 Accepting new patients
Providence Health & Services - Washington CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services Washington CurrentSince Apr 1, 2018 Accepting new patients

Locations

1911 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 481-2484

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

Interoperability endpoints

  • Direct secure messaging: lwalters217919@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1831162825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-481-5000",
            "fax_number": "907-481-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-481-5000",
            "fax_number": "907-481-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC TAX ID",
            "identifier": "920088665",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD4067",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

Verify at the official NPI Registry.