Jennifer Lee Walter, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

53-76944-021 Issued in KS

Practice address

410 E Spruce St
Garden City, KS 67846-5659

Phone

(620) 272-2579

Fax

(620) 272-2685

NPI assigned

May 27, 2015

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.walter@cccancer.ikm.direct-ci.com

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1851770523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674020256",
            "telephone_number": "785-823-0633",
            "fax_number": "303-764-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465659",
            "telephone_number": "620-272-2579",
            "fax_number": "620-272-2685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 15th St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Liberal",
            "state": "KS",
            "postal_code": "679012455",
            "country_code": "US",
            "telephone_number": "620-624-4700",
            "fax_number": "888-235-3625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 W Ross Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Dodge City",
            "state": "KS",
            "postal_code": "678017220",
            "country_code": "US",
            "telephone_number": "620-371-7200",
            "fax_number": "888-235-4591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2051 E Mary St",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "KS",
            "postal_code": "678463617",
            "country_code": "US",
            "telephone_number": "620-765-1450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dodge City",
            "state": "KS",
            "postal_code": "678016411",
            "country_code": "US",
            "telephone_number": "620-671-7200",
            "fax_number": "888-235-4591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-76944-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200631180A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201123060A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.walter@cccancer.ikm.drect-ci.com",
            "affiliation": "N",
            "address_1": "112 W Ross Blvd Ste D",
            "city": "Dodge City",
            "state": "KS",
            "country_code": "US",
            "postal_code": "678017220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.walter@cccancer.ikm.drect-ci.com",
            "affiliation": "N",
            "address_1": "410 E Spruce St",
            "city": "Garden City",
            "state": "KS",
            "country_code": "US",
            "postal_code": "678465659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Garden City, KS
• Providers in Garden City, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.