Active NPI
Deborah Koon Walls, PHARMD
- Pharmacist
- Danville, KY
National Provider Identifier
1134874480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 017439
- Practice address
- 60 Cassidy Way
Danville, KY 40422-8472 - Phone
- (859) 936-1222
- NPI assigned
- Feb 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017439 | KY | Primary |
Addresses
Primary practice location
60 Cassidy Way
Danville, KY 40422-8472
Mailing address
4435 Lebanon Rd
Danville, KY 40422-9626
Phone (404) 863-4575
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017439 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1134874480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4435 LEBANON RD",
"city": "DANVILLE",
"state": "KY",
"postal_code": "404229626",
"telephone_number": "404-863-4575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 CASSIDY WAY",
"city": "DANVILLE",
"state": "KY",
"postal_code": "404228472",
"telephone_number": "859-936-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "DEBORAH",
"middle_name": "KOON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-15",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "017439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.