Gloria Walters, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20665 Issued in MS

Practice address

100 Emancipation Dr
Hampton, VA 23667-0001

Phone

(757) 722-9961

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1952380909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "GLORIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "48081",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35088765",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "20665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490043000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P00806766",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I059650",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Michael Wallace Sr., M.D.
• Felicia Lee Wallace, LCSW
• Selina Samantha Wallace
• Kenneth William Waller, M.D.
• Walter Rudolph Wallingford, M.D.
• Betty R. Walton, M.A. CCC-SLP
• Moses Walusimbi Sr.
• Terezita Wamalwa
• Barbara A Ward, LCSW
• Beverly Washington, RN

• Anesthesiology Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.