John T Walters (NPI# 1215924659, PAC ID# 2062463391) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1215924659 |
| PAC ID by PECOS | 2062463391 |
| Professional Enrollment ID | I20050203000867 |
| Full Name | John T Walters |
| Organization Legal Name | TANANA VALLEY CLINIC LLC |
| Address |
1001 Noble St Fairbanks AK 99701-4948 |
| Phone Number | 9074593500 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2004 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5698056901 |
| Number of Group Practice Members | 93 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 020012 | FAIRBANKS MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1001 Noble St, Fairbanks, AK 99701-4948 | 9074593500 | TANANA VALLEY CLINIC LLC |
| 570 Riverstone Way, Suite 3, Fairbanks, AK 99709-2940 | 9074582655 | TANANA VALLEY CLINIC LLC |
| Organization Legal Name | TANANA VALLEY CLINIC LLC |
| Physicians | 92 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Ribar | Osteopathic Manipulative Medicine | Tanana Valley Clinic LLC | 1405 Kellum St, Suite 300, Fairbanks, AK 99701-4189 |
| Shelby A Braun | Registered Dietitian Or Nutrition Professional | Tanana Valley Clinic LLC | 1101 Noble St, Fairbanks, AK 99701-4924 |
| Nicholas P Cosentino | Internal Medicine | Tanana Valley Clinic LLC | 1650 Cowles St, Fairbanks, AK 99701-5907 |
| Dianna Kristeller | Certified Nurse Midwife (cnm) | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Lynn A Bolenbaugh | Physician Assistant | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Rebekah Burket | Psychologist, Clinical | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| James Timothy Foote | Allergy/immunology | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Tatiana Olson | Physician Assistant | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Jessica B Highfill | Obstetrics/gynecology | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Dennis W Mckevitt | Critical Care (intensivists) | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Street Address |
1001 NOBLE ST |
| City | FAIRBANKS |
| State | AK |
| Zip | 99701-4948 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dianna Kristeller | Certified Nurse Midwife (cnm) | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Lynn A Bolenbaugh | Physician Assistant | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Rebekah Burket | Psychologist, Clinical | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| James Timothy Foote | Allergy/immunology | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Tatiana Olson | Physician Assistant | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Jessica B Highfill | Obstetrics/gynecology | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Timothy Ryan | Diagnostic Radiology | Radiology Consultants A Professional Corporation | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Dennis W Mckevitt | Critical Care (intensivists) | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Marvin E Bergeson | Pediatric Medicine | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Peter John Dillon Jr. | Family Medicine | Tanana Valley Clinic LLC | 1001 Noble St, Fairbanks, AK 99701-4948 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carol J Davis | Chiropractic | 1018 College Rd, Fairbanks, AK 99701-1557 | |
| William A Tewson | Chiropractic | 29 College Rd, 8b1, Fairbanks, AK 99701-1739 | |
| Virginia R Lind | Optometry | 59 College Rd, Suite 209, Fairbanks, AK 99701-1757 | |
| Aimee Desiree Burgess | Chiropractic | Life Sprout Chiropractic LLC | 505 Illinois St, Suite 4, Fairbanks, AK 99701-2946 |
| Jeremy Cole Fulk | Optometry | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| David J Peterson | Optometry | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| Damien R Delzer | Optometry | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| Stanley R Fuller | Ophthalmology | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| Natalie E Macke | Optometry | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| Rebecca S Wilbur | Optometry | Eye Clinic of Fairbanks Inc | 116 Minnie St, Fairbanks, AK 99701-3006 |
| Find all physicians in zip 99701 | |||
| City | FAIRBANKS |
| Zip Code | 99701 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FAIRBANKS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on John T Walters.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.