Individual provider Active NPI

Jessica Walker, LLPC

  • Community Health Worker
  • Livonia, MI
National Provider Identifier
1003260282
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
6401014806 Issued in MI
Practice address
37450 Schoolcraft Rd
Livonia, MI 48150-1082
Phone
(734) 458-4601
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 6401014806 MI Primary

Addresses

Primary practice location

37450 Schoolcraft Rd
Livonia, MI 48150-1082

Mailing address

37450 Schoolcraft Rd
Livonia, MI 48150-1082
Phone (734) 458-4601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401014806MIMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hegira PastSince Feb 16, 2020 Accepting new patients
Hegira PastSince Feb 16, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1003260282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37450 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501082",
            "telephone_number": "734-458-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37450 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501082",
            "telephone_number": "734-458-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JESSICA",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "6401014806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.