Active NPI
Lucas Walker
- Pharmacist
- Lacey, WA
National Provider Identifier
1104200351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60658441
- Practice address
- 5110 Yelm Hwy SE
Lacey, WA 98503-5060 - Phone
- (360) 252-2907
- NPI assigned
- Jul 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-16933 | KS | |
| Pharmacist | 183500000X | PH60658441 | WA | Primary |
Addresses
Primary practice location
5110 Yelm Hwy SE
Lacey, WA 98503-5060
Mailing address
5110 Yelm Hwy SE
Lacey, WA 98503-5060
Phone (360) 252-2907
Other practice location 1
335 SW MacVicar Ave
Topeka, KS 66606-2441
Phone (785) 379-2341
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-16933 | Other | KS | PHARMACY LICENSE |
| PH60658441 | Other | WA | PHARMACY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1-16933 | KS | MD | Pharmacist |
| PH60658441 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Lacey, WA
- NPI 1275941361
-
- Community/Retail Pharmacy
- Topeka, KS
- NPI 1437555232
-
- Community/Retail Pharmacy
- Eastvale, CA
- NPI 1770458945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667692800000",
"number": "1104200351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5110 YELM HWY SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035060",
"telephone_number": "360-252-2907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5110 YELM HWY SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035060",
"telephone_number": "360-252-2907"
}
],
"practiceLocations": [
{
"address_1": "335 SW MacVicar Ave",
"address_purpose": "LOCATION",
"city": "Topeka",
"state": "KS",
"postal_code": "666062441",
"country_code": "US",
"telephone_number": "785-379-2341",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "LUCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-17",
"last_updated": "2022-11-06",
"certification_date": "2022-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-16933",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60658441",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "1-16933",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "PH60658441",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.