EDWINA SUE WALTHALL (APN) – Obstetrics & Gynecology Nurse Practitioner, NPI 1801026620

EDWINA SUE WALTHALL (APN) is a healthcare provider. based in Little rock, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. A03147 (AR). The NPI Number for EDWINA SUE WALTHALL (APN) is 1801026620

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
EDWINA SUE WALTHALL (APN)
NPI
1801026620
Phone
(501) 251-5276
Address
4301 W MARKHAM ST
Enumeration Date
15 July 2009
Last Update Date
10 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2007 (19 years ago)
PAC ID
4486709219
Group Practice PAC ID
4082528955
Professional Enrollment ID
I20090831000686
Address ID
AR722057101LI4301XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

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Provider Addresses for EDWINA SUE WALTHALL (APN)

  • University of Arkansas Medical Sciences Medical Center, 4301, West Markham Street, Pulaski Heights, Little Rock, Pulaski County, Arkansas, 72205, United States

    LITTLE ROCK, AR 722057101

    Phone: (501) 251-5276

    Fax: (501) 280-3142

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090831000686INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082528955View full group profile
NameSpecialtyState
N E U R O L O G YAR
-AR
Internal MedicineNY
Internal Medicine, NephrologyAR
-AR
-AR
Nurse PractitionerAR
P S Y C H I A T R YAR
-AR
-AR

Reviews

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Frequently asked questions

What is the standard ID for EDWINA SUE WALTHALL (APN) in the U.S.?
In the U.S., EDWINA SUE WALTHALL (APN) is identified by NPI 1801026620.
Does the public listing show EDWINA SUE WALTHALL (APN) as active?
EDWINA SUE WALTHALL (APN)'s NPI record reflects an active status in NPPES.
What services align with EDWINA SUE WALTHALL (APN)'s listing?
EDWINA SUE WALTHALL (APN)'s public classification highlights Obstetrics & Gynecology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to EDWINA SUE WALTHALL (APN)?
The directory associates EDWINA SUE WALTHALL (APN) with Little Rock, Arkansas. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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