Courtney Danielle Walters, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2716 Issued in NC

Practice address

818 Pine Grove Dr
Wilmington, NC 28409-5600

Phone

(910) 777-5971

NPI assigned

Jan 22, 2022

Last updated

Sep 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bladen Eye Center OD PAGroup PAC ID 1355469586, 2 clinicians

Omni Eye Services OD PLLCGroup PAC ID 9032204508, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bladen Eye Center OD PLLC

  dba Bladen Eye Center

  • Optometrist
  • Elizabethtown, NC
  • NPI 1336299684
  Medicare reassignment Care Compare group NPD
• Omni Eye Services OD PLLC

  • Optometrist
  • Wilmington, NC
  • NPI 1225188071
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1871245662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 SIR TYLER DR APT 401",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058549",
            "telephone_number": "910-723-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 PINE GROVE DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284095600",
            "telephone_number": "910-777-5971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "283378807",
            "country_code": "US",
            "telephone_number": "910-862-4268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-22",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Walsh
• Susan Elizabeth Walsh, PHARMD, RPH
• Lena Walshe
• Walter J. Wulf, DDS, P.a.
• Rebecca L Walter, LPCC, LCMHC
• Kenneth Christian Walters, MD
• Leighann Walters, RPH
• Dana Carroll Walton, PT, DPT, CWS
• Laurence S Wang, M.D.
• Yifeng Wang, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.