Kim Walters OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1726 Issued in NC

Legal business name

KIM WALTERS OD PA

Practice address

49 N Buncombe School Rd
Weaverville, NC 28787-9608

Phone

(828) 645-0061

Fax

(828) 645-0602

NPI assigned

Jun 19, 2007

Last updated

Jul 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberley Dawn Walters, O.D., P.A.NPI 1598769093

Title

Doctor

Phone

(828) 645-0061

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• OPTIX EYECARE Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberley Dawn Walters, O.D.

  • Optometrist
  • Weaverville, NC
  • NPI 1598769093
  Medicare reassignment Authorized official
• Trisha M Roberts, OD

  • Optometrist
  • Greer, SC
  • NPI 1780731471
  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1831394964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 564",
            "city": "WEAVERVILLE",
            "state": "NC",
            "postal_code": "287870564",
            "telephone_number": "828-645-0061",
            "fax_number": "828-645-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 N BUNCOMBE SCHOOL RD",
            "city": "WEAVERVILLE",
            "state": "NC",
            "postal_code": "287879608",
            "telephone_number": "828-645-0061",
            "fax_number": "828-645-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM WALTERS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "828-645-0061",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.D., P.A."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909003",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD OF NC",
            "identifier": "09003",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICAE",
            "identifier": "410049043",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTIX EYECARE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Weaverville, NC
• Providers in Weaverville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.