Active NPI
Georgette Walter, ARNP
- Nurse Practitioner
- Louisville, KY
National Provider Identifier
1861415515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 778P
- Practice address
- 4041 Preston Hwy
Louisville, KY 40213-1601 - Phone
- (502) 375-3242
- Fax
- (502) 375-4331
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 778P | KY | Primary |
Addresses
Primary practice location
4041 Preston Hwy
Louisville, KY 40213-1601
Mailing address
PO Box 950245
Louisville, KY 40295-0245
Phone (502) 588-9490
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009450 | Other | KY | SIHO - NORTON ICC |
| 11480571 | Other | CAQH | |
| 78000064 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 778P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elderserve, Inc. | Past | Accepting new patients | |
| Community Medical Associates, Inc. | Nurse Practitioner | Past | Accepting new patients |
| Norton Enterprises, Inc. | Past | Accepting new patients | |
| Community Medical Associates, Inc. | Nurse Practitioner | Past | Accepting new patients |
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 and National Provider Directory roles.
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Nurse Practitioner
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-
- Urgent Care Clinic/Center
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- NPI 1104863562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335484800000",
"number": "1861415515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 950245",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402950245",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 PRESTON HWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402131601",
"telephone_number": "502-375-3242",
"fax_number": "502-375-4331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "GEORGETTE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2012-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "778P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIHO - NORTON ICC",
"identifier": "009450",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11480571",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78000064",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.