Active NPI
Walter Palkovitch, RN
- General Practice Registered Nurse
- Winterhaven, CA
National Provider Identifier
1982027348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- NUR R 12772
- Practice address
- One Indian Hill Road
Winterhaven, CA 92283 - Phone
- (760) 572-4100
- Fax
- (760) 572-2133
- NPI assigned
- Jan 21, 2014
- Last updated
- Jan 21, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | NUR R 12772 | AK | Primary |
Addresses
Primary practice location
One Indian Hill Road
Winterhaven, CA 92283
Mailing address
PO Box 1638
Yuma, AZ 85366
Phone (760) 572-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NUR R 12772 | AK | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390262400000",
"number": "1982027348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1638",
"city": "YUMA",
"state": "AZ",
"postal_code": "85366",
"telephone_number": "760-572-4100",
"fax_number": "760-572-2133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE INDIAN HILL ROAD",
"city": "WINTERHAVEN",
"state": "CA",
"postal_code": "92283",
"telephone_number": "760-572-4100",
"fax_number": "760-572-2133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALKOVITCH",
"first_name": "WALTER",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-21",
"last_updated": "2014-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "AK",
"license": "NUR R 12772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winterhaven, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.