Individual provider Active NPI

Katie S. Walton, PA-C

  • Surgical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1932235124
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0003355 Issued in MD
Practice address
5401 Old Court Road
Baltimore, MD 21133
Phone
(410) 496-7500
NPI assigned
Feb 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0003355 MD Primary

Addresses

Primary practice location

5401 Old Court Road
Baltimore, MD 21133

Mailing address

4081 Fragile Sail Way
Ellicott City, MD 21042-5023
Phone (302) 740-6102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20090709000305 MD Practitioner - Physician Assistant 8921150780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mep Observation Services LLCGroup PAC ID 2365611845, 42 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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 1

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": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1932235124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 FRAGILE SAIL WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425023",
            "telephone_number": "302-740-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT ROAD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21133",
            "telephone_number": "410-496-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "KATIE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0003355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.