DR. KATHLEEN LUCILLE WALSH (NPI# 1497785695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497785695 |
| Entity Type | Individual |
| Full Name | DR. KATHLEEN LUCILLE WALSH |
| Other Name | DR. KATHLEEN LUCILLE WALSH-RENE |
| Credential | M.D. |
| Practice Address |
Clark Clinic Fort Bragg NC 28310-0001 |
| Mailing Address |
Clark Clinic Bastogne Extension Fort Bragg NC 28310-0001 |
| Practice Telephone | 9109779755 |
| Practice Fax Number | 9109078011 |
| Mailing Telephone | 9109079755 |
| Mailing Fax Number | 9109078011 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 200101507 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134632185 | Kathleen Walsh | Clinic/Center | 129 W Gaillard St, Glendora, CA 91740-5023 | 2017-11-13 |
| 1306213202 | Kathleen Walsh | Licensed Practical Nurse | 52 Elmhurst Ave, Medford, NY 11763-3600 | 2015-08-26 |
| 1124400247 | Kathleen Walsh | Counselor | 138 Utica Street Apartment 1, Quincy, MA 02169 | 2015-06-25 |
| 1992137087 | Kathleen M Walsh | Speech-Language Pathologist | 70 W Burton Pl, Apt 403, Chicago, IL 60610-1444 | 2013-07-31 |
| 1609147628 | Kathleen M Walsh | Social Worker | 155 N Michigan Av, #523, Chicago, IL 60601 | 2012-01-23 |
| 1518197680 | Kathleen Elizabeth Walsh | Acupuncturist | W340n6204 Breezy Point Rd, Oconomowoc, WI 53066-5111 | 2009-07-22 |
| 1932375995 | Kathleen Elizabeth Walsh | Urology | 1310 Henry Clay Ave, New Orleans, LA 70118-6009 | 2008-04-30 |
| 1205034048 | Kathleen P Walsh | Speech-Language Pathologist | 22 Moulton Rd, Freedom, NH 03836-5021 | 2007-07-03 |
| 1912053059 | Kathleen Walsh | Occupational Therapist | 1042 Masterson Dr, Baton Rouge, LA 70810-4729 | 2007-01-25 |
| 1922642420 | Kathleen Mary Walsh | Specialist | 101 Stage Rd, Monroe, NY 10950-3512 | 2019-10-29 |
| Street Address |
CLARK CLINIC |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750511176 | Jeannie Schumpert Dias | Internal Medicine | 2817 Reilly St Stop A, Womack Army Medical Center, Mcxc Dom, Fort Bragg, NC 28310-7831 | 2009-07-20 |
| 1487665410 | Jason Kirkman | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-08-11 |
| 1982663563 | Jo Ellen Hirsch | Internal Medicine | Bldg M-4861 Logistics Ave, Joel Health Clinic, Fort Bragg, NC 28310-0001 | 2006-03-21 |
| 1184692113 | Young Sammy Choi | Internal Medicine | Department of The Army, Wamc Stop A, 2817 Reilly Road, Fort Bragg, NC 28310-7301 | 2006-03-08 |
| 1376535369 | Jennifer E Yates | Internal Medicine | Womack Internal Medicine, Reilly Road, Fort Bragg, NC 28310-0001 | 2005-08-17 |
| 1851754279 | Elizabeth Levine | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2016-04-02 |
| 1154765345 | Karoline Johnson | Internal Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2013-04-18 |
| 1316266554 | Nathan Lewis Boyer | Internal Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2010-05-27 |
| 1821225129 | Aaron Richard Farmer | Internal Medicine | 2817 Reilly St, Womack Army Medical Center, Fort Bragg, NC 28310-7324 | 2009-06-15 |
| 1033314117 | Julie Lynn Jones | Internal Medicine | Womack Army Medical Ctr, Department of Internal Medicine, Fort Bragg, NC 28310-0001 | 2007-06-18 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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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.