Individual provider Active NPI

Walter Bradley Edington, NP

  • Family Nurse Practitioner
  • Calhoun City, MS
National Provider Identifier
1881077717
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
864373 Issued in MS
Practice address
140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone
(662) 628-6611
Fax
(662) 628-6300
NPI assigned
Jul 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 864373 MS Primary

Addresses

Primary practice location

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

1002 E Madison St Ste 2
Houston, MS 38851-2428
Phone (662) 456-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209000298 MS Practitioner - Nurse Practitioner 8527369941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

112 Medical Arts Dr
Calhoun City, MS 38916-9721
Phone (662) 628-1274

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone (662) 628-6611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital-Calhoun Inc CurrentSince Dec 5, 2022 Accepting new patients
Southern Health Corp. of Houston, Inc Current Accepting new patients
Baptist Memorial Hospital-Calhoun Inc CurrentSince Dec 5, 2022 Accepting new patients
Calhoun Health Services Past Accepting new patients

Locations

112 Medical Arts Dr
Calhoun City, MS 38916
Phone (662) 628-1274

1002 E Madison St
Ste 2
Houston, MS 38851
Phone (662) 456-3000

1002 E Madison St
Houston, MS 38851
Phone (601) 456-3701

140 Burke Calhoun City Rd
Slate Spring, MS 38916
Phone (662) 628-6611

Interoperability endpoints

  • Direct secure messaging: wedington70274@direct.bmhcc.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1881077717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BURKE CALHOUN CITY RD",
            "city": "CALHOUN CITY",
            "state": "MS",
            "postal_code": "389169690",
            "telephone_number": "662-628-6611",
            "fax_number": "662-628-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 E Madison St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "MS",
            "postal_code": "388512428",
            "country_code": "US",
            "telephone_number": "662-456-3000",
            "fax_number": "662-456-9439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDINGTON",
        "first_name": "WALTER",
        "middle_name": "BRADLEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "864373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun City, MS

Sources for this page

Verify at the official NPI Registry.