Individual provider Active NPI

Lucas Walker

  • Pharmacist
  • Lacey, WA
National Provider Identifier
1104200351
Registry record updated Nov 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60658441 Issued in WA
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

Updated by the provider on Nov 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1-16933OtherKSPHARMACY LICENSE
PH60658441OtherWAPHARMACY 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

LicenseStateTypeSpecialty
1-16933KSMDPharmacist
PH60658441WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. PastSince Nov 13, 2022 Accepting new patients
Walmart Inc. PastSince Nov 13, 2022 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.

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.

Verify at the official NPI Registry.