Individual provider Active NPI

Ethan Pace Walker, MD

  • Family Medicine Physician
  • Paducah, KY
National Provider Identifier
1124551809
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56913 Issued in KY
Practice address
6321 Kentucky Dam Rd
Paducah, KY 42003-9471
Phone
(270) 898-2444
Fax
(618) 453-1102
NPI assigned
Apr 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56913 KY Primary

Addresses

Primary practice location

6321 Kentucky Dam Rd
Paducah, KY 42003-9471

Mailing address

6321 Kentucky Dam Rd
Paducah, KY 42003-9471

Other practice location 1

100 Clint Hill Blvd Ste 100
Paducah, KY 42001-6771
Phone (270) 441-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826003195 KY Practitioner - Family Practice 3072841493 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Ky Urgent Care LLCGroup PAC ID 2860832763, 9 clinicians
Mercy Health Physicians Kentucky LLCGroup PAC ID 1153488648, 20 clinicians

Practice addresses (Care Compare)

100 Clint Hill Blvd
Suite 100
Paducah, KY 42001-6771
Phone (270) 441-4357

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 444-2444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56913KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Ky Urgent Care LLC CurrentSince Jun 1, 2024 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Oct 16, 2023 Accepting new patients
Mercy Health Physicians Kentucky LLC Family Medicine CurrentSince Sep 11, 2022 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Oct 16, 2023 Accepting new patients
Mercy Health-Lourdes Hospital LLC Past Accepting new patients

Locations

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

200 Clint Hill Blvd
Paducah, KY 42001
Phone (270) 442-9461

100 Clint Hill Blvd
Ste 100
Paducah, KY 42001
Phone (270) 441-4357

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

6321 Kentucky Dam Rd
Paducah, KY 42003
Phone (270) 898-2444

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

Interoperability endpoints

  • Direct secure messaging: ewalker1349022@direct.bsmhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1124551809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6321 KENTUCKY DAM RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420039471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6321 KENTUCKY DAM RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420039471",
            "telephone_number": "270-898-2444",
            "fax_number": "618-453-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Clint Hill Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420016771",
            "country_code": "US",
            "telephone_number": "270-441-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ETHAN",
        "middle_name": "PACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-09",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "56913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.