JONI M WALTON NP
NPI 1043651235
Nurse Practitioner in Shelby, MT

NPI Status: Active since July 16, 2013

Contact Information

670 PARK AVE
SHELBY, MT
ZIP 59474
Phone: (406) 434-3100
Fax: (406) 434-3143

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  • Individual
  • Female
  • Nurse Practitioner
  • Accepts Insurance
  • PECOS Enrolled

About JONI WALTON

This page provides the complete NPI Profile along with additional information for Joni Walton, a provider established in Shelby, Montana with a medical specialization in Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1043651235 assigned on July 2013. The practitioner's primary taxonomy code is 363L00000X with license number 13560 (MT). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1043651235
Provider Name
JONI M WALTON NP
Gender
Female
Entity Type
Individual
Location Address
670 PARK AVE SHELBY, MT 59474
Location Phone
(406) 434-3100
Location Fax
(406) 434-3143
Mailing Address
715 GETCHELL ST HELENA, MT 59601
Mailing Phone
(406) 443-8233
Mailing Fax
(406) 434-3143
Is Sole Proprietor?
No
Enumeration Date
07-16-2013
Last Update Date
03-12-2021
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A nurse practitioner (NP) like Joni Walton is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
13560
License State
MT
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Peak PPO Bronze HDHP - PPO
  • Peak PPO Bronze Standard - PPO
  • Peak PPO Catastrophic - PPO
  • Peak PPO Gold - PPO
  • Peak PPO Gold Standard - PPO
  • Peak PPO Silver - PPO
  • Peak PPO Silver Standard - PPO
  • Plus Bronze - PPO
  • Plus Bronze Standard - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • PEAK PPO BRONZE - PPO
  • PEAK PPO BRONZE HDHP - PPO
  • PEAK PPO GOLD - PPO
  • PEAK PPO GOLD HDHP - PPO
  • PEAK PPO SILVER - PPO
  • PEAK PPO SILVER HDHP - PPO
  • Plus Bronze HDHP - PPO
  • Plus Gold HDHP - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1043651235MEDICAID (05)MT 
13560OTHER (01)MTSTATE LICENSE

Medicare Participation & PECOS Enrollment Status

Joni Walton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    3 DME suppliers used 13 Medicare Claims 18 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    4 DME suppliers used 21 Medicare Claims 70 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    3 DME suppliers used 25 Medicare Claims 27 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    5 DME suppliers used 42 Medicare Claims 44 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    1 DME suppliers used 24 Medicare Claims 24 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    2 DME suppliers used 14 Medicare Claims 14 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    1 DME suppliers used 12 Medicare Claims 3000 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous

A fecal occult blood test is a screening tool for colorectal cancer. It checks for tiny amounts of blood in your stool that can't be seen with the naked eye. The immunoassay method can test 1-3 samples at once. This helps detect cancer early, when treatment is most effective.

This service was performed 29 times for 29 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 22 times for 16 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 21 times for 16 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 59474 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.97
  • Minimum New Patient Price $56.81
  • Maximum New Patient Price $172.26
  • Average New Patient Copayment $21.99
  • Minimum New Patient Copayment $14.2
  • Maximum New Patient Copayment $43.06

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.16
  • Minimum Established Patient Price $18.24
  • Maximum Established Patient Price $140.32
  • Average Established Patient Copayment $25.04
  • Minimum Established Patient Copayment $4.56
  • Maximum Established Patient Copayment $35.08

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043651235, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
2
Unchanged
Pos 9
3
Doubled → 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 6 → 12 → 3 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 2 + 5 + 2 + 2 + 6 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1043651235.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Family Medicine
670 PARK AVE
SHELBY, MT 59474
Family Medicine
670 PARK AVE
SHELBY, MT 59474
Midwife
670 PARK AVE
SHELBY, MT 59474
Counselor (Mental Health)
670 PARK AVE
SHELBY, MT 59474
Podiatrist
670 PARK AVE
SHELBY, MT 59474
Social Worker
670 PARK AVE
SHELBY, MT 59474
Counselor (Mental Health)
670 PARK AVE
SHELBY, MT 59474
Family Medicine
670 PARK AVE
SHELBY, MT 59474
Counselor (Mental Health)
670 PARK AVE
SHELBY, MT 59474
Counselor (Mental Health)
670 PARK AVE
SHELBY, MT 59474
Social Worker (Clinical)
670 PARK AVE
SHELBY, MT 59474
Clinic/Center (Multi-Specialty)
670 PARK AVE
SHELBY, MT 59474

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043651235, enumerated as an "individual" on July 16, 2013.

The provider is located at 670 PARK AVE SHELBY, MT 59474 and the phone number is (406) 434-3100.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Mountain Health CO-OP, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.