Teresa Cantrell Walters, FNP is a medicare enrolled "Nurse Practitioner - Family" in Russell, Pennsylvania. Her current practice location is
20 Pinegrove Blvd, Russell, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(205) 452-9789.
Teresa Cantrell Walters is licensed to practice in Pennsylvania (license number SP032543) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1649017807.
Provider's Profile
| Full Name | Teresa Cantrell Walters |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 20 Pinegrove Blvd, Russell, Pennsylvania |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1649017807
- Provider Enumeration Date: 07/13/2024
- Last Update Date: 04/25/2025
Medicare PECOS Information:
- PECOS PAC ID: 9234648411
- Enrollment ID: I20250530000560
Medical Identifiers
Medical identifiers for Teresa Cantrell Walters such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1649017807 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 1-168597 (Alabama) | Secondary |
| 163W00000X | Registered Nurse | RN800330 (Pennsylvania) | Secondary |
| 163W00000X | Registered Nurse | 975616 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 1-168597 (Alabama) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 356260 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | SP032543 (Pennsylvania) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Teresa Cantrell Walters allows following entities to bill medicare on her behalf.
| Entity Name | Corry Memorial Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255967956
PECOS PAC ID: 3971581174
Enrollment ID: O20201211000131 |
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| Entity Name | Corry Memorial Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124406376
PECOS PAC ID: 3971581174
Enrollment ID: O20240815004074 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teresa Cantrell Walters is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Teresa Cantrell Walters, FNP
3132 Sydenton Dr,
Hoover, AL 35244-5627
Ph: (205) 452-9789 | Teresa Cantrell Walters, FNP
20 Pinegrove Blvd,
Russell, PA 16345-1118
Ph: (205) 452-9789 |
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