KERMIT L. WALTERS JR. (NPI# 1083628648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083628648 |
| Entity Type | Individual |
| Full Name | KERMIT L. WALTERS JR. |
| Credential | MD |
| Practice Address |
1910 Jackson St Monroe LA 71202-2532 |
| Practice Telephone | 3183257998 |
| Practice Fax Number | 3183980888 |
| Mailing Telephone | 3183257998 |
| Mailing Fax Number | 3183980888 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2008-06-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 12847 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1313220 | 05 |
| Street Address |
1910 JACKSON ST |
| City | MONROE |
| State | LA |
| Zip Code | 71202-2532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679042287 | Nightingail Healthcare Resources | Clinic/Center | 1910 Jackson St, Monroe, LA 71202-2532 | 2018-11-13 |
| 1942755863 | Wanda G Smith | Registered Nurse | 1910 Jackson St, Monroe, LA 71202 | 2016-08-20 |
| 1932207081 | Urban Drug Store Inc | Pharmacy | 1910 Jackson St, Monroe, LA 71202-2532 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170726 | Ap&g Transportation LLC | Non-emergency Medical Transport (VAN) | 211 Malvern St., Monroe, LA 71202 | 2020-09-30 |
| 1902419625 | Marilyn F Goldman | Non-emergency Medical Transport (VAN) | 1001 Wilton Dr, Monroe, LA 71202 | 2020-08-24 |
| 1114583069 | Brandon Rashaard Collins | Case Manager/Care Coordinator | 5504 Robinson Drive, Monroe, LA 71202 | 2019-05-16 |
| 1285131326 | Jerrel Stills | Counselor | 296 Forest Oaks Rd, Monroe, LA 71202 | 2018-04-06 |
| 1164930269 | Jakira Gibson | Case Manager/Care Coordinator | 308 Vegas Dr, Monroe, LA 71202 | 2018-01-11 |
| 1457870321 | Whitney Nicole Allen | Counselor | 806 North 31st Street, Monroe, LA 71202 | 2017-09-12 |
| 1821535527 | Collins Wade | Counselor | 808 S. Second St., Monroe, LA 71202 | 2017-01-20 |
| 1821533639 | Geoi Smart | Social Worker | 1602 Oaklawn Dr, Monroe, LA 71202 | 2017-01-03 |
| 1699124214 | Melody Miller | Case Manager/Care Coordinator | 205 Stacy Dr Apt A, Monroe, LA 71202 | 2016-06-04 |
| 1548618192 | Samuel Anjera Spivey Jr. | Case Manager/Care Coordinator | 110 Blackwood Dr, Monroe, LA 71202 | 2016-05-24 |
| Find all providers in zip 71202 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972124832 | Jessica Womack | Family Medicine | 527 W Hurd Rd, Monroe, MI 48162-9205 | 2020-05-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1376000620 | Paladina Health, LLC | Family Medicine | Paladina Health Monroe Campus Park, 1640 A Campus Park Drive, Monroe, NC 28112 | 2019-02-22 |
| 1457822991 | Affinity Health Group, LLC | Family Medicine | 920 Oliver Rd Ste A2, Monroe, LA 71201-5702 | 2018-12-10 |
| 1144601121 | Rebecca Redding | Family Medicine | 924 W Spring St Ste A, Monroe, GA 30655-1751 | 2015-06-15 |
| 1285069088 | Geaux Family Health, LLC | Family Medicine | 2408 Duval Dr, Suite 1, Monroe, LA 71201-2986 | 2013-09-11 |
| 1033559844 | Mvhe, Inc | Family Medicine | 20 Overbrook Dr Ste C, Monroe, OH 45050-1147 | 2013-06-26 |
| 1982048237 | Erin Robinson Breard | Family Medicine | 3995 Sterlington Rd, Ste A, Monroe, LA 71203-3723 | 2013-04-17 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1598015968 | Urban Medical Clinic, Inc. | Family Medicine | 1910 Jackson St., Monroe, LA 71202-2532 | 2012-09-13 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.