Nikki Anderson Walden, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

L8999 Issued in TX

Practice address

4325 N Josey LN
Suite 300
Carrollton, TX 75010-4635

Phone

(972) 820-9333

Fax

(972) 492-8600

NPI assigned

Aug 8, 2006

Last updated

May 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Nikki a Walden MD PA

  • Specialist
  • Carrollton, TX
  • NPI 1063673879
  NPD (past)
• Northern Bay Womens Health Center, PA

  • Gynecology Physician
  • Plano, TX
  • NPI 1295748168
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1942210398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118383",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750118383",
            "telephone_number": "972-820-9333",
            "fax_number": "972-492-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 N JOSEY LN",
            "address_2": "SUITE 300",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104635",
            "telephone_number": "972-820-9333",
            "fax_number": "972-492-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "NIKKI",
        "middle_name": "ANDERSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L8999",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L8999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARKLAND",
            "identifier": "16244",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0066MH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10016066",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173131701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "4501037598",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4732959",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-1216)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-2625)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3198)
• Wal-Mart Stores Texas, LLC
• Wal-Mart Stores Texas, LP (Vision Center 30-1216)
• Walgreen Co (Walgreens #04014)
• Walgreen Co (Walgreens #10816)
• Walgreen Co (Walgreens #03803)
• Amy Walker, MS,CCC,SLP
• Cheryl Lynn Walker

• Specialist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.