Individual provider Active NPI

Georgette Walter, ARNP

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1861415515
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
778P Issued in KY
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

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
009450OtherKYSIHO - NORTON ICC
11480571OtherCAQH
78000064MedicaidKY

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

LicenseStateTypeSpecialty
778PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.