RICHARD WALTERS
NPI 1154013829
Student in an Organized Health Care Education/Training Program in Jonesboro, AR

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 22, 2023PECOS EnrolledAccepts Medicare Assignment

4800 E JOHNSON AVE, JONESBORO, AR 72405(870) 936-1000 Get Directions Write a Review

NPPES record last updated: May 22, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Richard Walters NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD WALTERS (NPI 1154013829) is an individual student in an organized health care education/training program in Jonesboro, Arkansas and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (2023).

NPPES Registry Identity

NPI1154013829

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameRICHARD WALTERS

Location Address4800 E JOHNSON AVEJonesboro, AR 72405-8413

Mailing Address4909 Reserve Blvd Apt C202Jonesboro, AR 72405-8358

Phone(870) 936-1000

Sole ProprietorYes

Medical School CMSUniversity Of Kansas School Of Med (kc/wich/sal)Graduated 2023

Enumeration DateMay 22, 2023

NPPES CertifiedMay 22, 2023

✔ NPI 1154013829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4800 E JOHNSON AVE, Jonesboro, AR 72405

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Richard Walters is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668832767

PECOS Enrollment IDI20250826004842

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.