Active NPI
Renee Walters, D.O
- Internal Medicine Physician
- Kankakee, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 24350
- Practice address
- 350 N Wall St
Kankakee, IL 60901-2901 - Phone
- (815) 928-6274
- NPI assigned
- May 9, 2013
- Last updated
- Jun 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 24350 | MS | Primary |
Addresses
Primary practice location
350 N Wall St
Kankakee, IL 60901-2901
Mailing address
42 Hamilton Dr
Athens, OH 45701-6694
Phone (740) 593-7295
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Ohio State University College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258
830 S Gloster St
Tupelo, MS 38801-4934
830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Medical Center | Current | Accepting new patients | |
| North Mississippi Medical Center Inc. | Internal Medicine | Current | Accepting new patients |
| North Mississippi Medcial Center, Inc. | Current | Accepting new patients | |
| North Mississippi Medical Center Inc | Current | Accepting new patients | |
| North Mississippi Medical Center, Inc. | Past | Accepting new patients |
Locations
830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136
Interoperability endpoints
- reneewalters@nmhs.medalliesdirect.net
Organizations & group practices 5
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.
-
dba Behavioral Health Center
- Psychologist
- Tupelo, MS
- NPI 1972608347
-
dba Radiology Consultants
- Diagnostic Radiology Physician
- Tupelo, MS
- NPI 1902762487
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1376969683
-
dba Medical Center Hospitalists
- Internal Medicine Physician
- Tupelo, MS
- NPI 1609243351
-
dba North Mississippi Medical Center
- General Acute Care Hospital
- Tupelo, MS
- NPI 1598875460
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba North Mississippi Medical Center
- General Acute Care Hospital
- Tupelo, MS
- NPI 1598875460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1942645486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 HAMILTON DR",
"city": "ATHENS",
"state": "OH",
"postal_code": "457016694",
"telephone_number": "740-593-7295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N WALL ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012901",
"telephone_number": "815-928-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "RENEE",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-09",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "24350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.