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Export Provider Record NPI 1124697305
Nicole J WalshPNP
Active
NPI Number1124697305
NPI TypeNPI-1 Individual
SpecialtyNurse Practitioner, Pediatrics
Provider Details
NPI1124697305
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2021-06-22
Last Updated2023-07-07
Mailing Address601 Elmwood Ave Box 278984
Rochester, NY 14642-0001
United States
Phone: (585) 275-2808 | Fax: (585) 275-3683
📍 View Map
Primary Practice Address200 E River Rd
Rochester, NY 14623-1212
United States
Phone: (585) 275-2808 | Fax: (585) 275-3683
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207XS0106X – Orthopaedic Surgery, Hand SurgeryNY383255
Yes363LP0200X – Nurse Practitioner, PediatricsNYF383255
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About NPI 1124697305

Nicole J Walsh PNP is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1124697305. The primary specialty listed is Nurse Practitioner, Pediatrics. The provider is located in Rochester, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2021-06-22. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124697305?

NPI 1124697305 belongs to Nicole J Walsh PNP, a Nurse Practitioner, Pediatrics in Rochester, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124697305 active?

The current status of NPI 1124697305 in the NPPES registry is Active. The record was last updated on 2023-07-07.

What specialty is NPI 1124697305?

NPI 1124697305 is classified under the taxonomy Nurse Practitioner, Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124697305?

You can verify NPI 1124697305 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124697305?

The primary practice address on file for NPI 1124697305 is 200 E River Rd, Rochester, NY 14623-1212. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124697305 issued?

NPI 1124697305 was first issued (enumerated) on 2021-06-22. The NPPES record was last updated on 2023-07-07.

Practice Location Map

Nicole J Walsh is located at 200 E River Rd, Rochester, NY. Use the map below to find directions or verify the practice location.

📍 200 E River Rd, Rochester, NY 14623-1212  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Nicole J Walsh. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1124697305. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Orthopaedic Surgery, Hand Surgery383255NY
Nurse Practitioner, PediatricsF383255NY
Data Verified from CMS NPPES Last synced: 2026-06-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162