Terry Jane Walters, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

281388 Issued in NY

Practice address

102 Black Mountain LN
Au Sable Forks, NY 12912-4722

Phone

(301) 646-2903

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1891883666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BLACK MOUNTAIN LN",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "129124722",
            "telephone_number": "301-646-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BLACK MOUNTAIN LN",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "129124722",
            "telephone_number": "301-646-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "TERRY",
        "middle_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "281388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Atchinson Miller, SLP
• George Peter Najim, DDS
• Laurel M Rosenthal, MD
• George Sarandev, DDS
• Kasey Snow
• Johnnie Jacqueline Wren, M.D.

• Internal Medicine Physician in Au Sable Forks, NY
• Providers in Au Sable Forks, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.