Individual provider Active NPI

Bruce Walker

  • Mental Health Counselor
  • Waynesboro, TN
National Provider Identifier
1144870379
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
950 Andrew Jackson Drive
Waynesboro, TN 38485-3848
Phone
(931) 253-2140
NPI assigned
Sep 19, 2019
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1369 TN
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

950 Andrew Jackson Drive
Waynesboro, TN 38485-3848

Mailing address

950 Andrew Jackson Drive
Waynesboro, TN 38485

Other identifiers 1

IdentifierTypeStateIssuer
01369OtherTNLADAC II

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Waynesboro

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204003331 TN Practitioner - Mental Health Counselor 7911437009

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

36 Pemberton CV
Jackson, TN 38305-5514

4128 Old Jackson Rd
Bells, TN 38006-4261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1369TNMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1144870379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 ANDREW JACKSON DRIVE",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "38485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 ANDREW JACKSON DRIVE",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384853848",
            "telephone_number": "931-253-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRUCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1369",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADAC II",
            "identifier": "01369",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Waynesboro",
            "affiliation": "N",
            "address_1": "950 Andrew Jackson Drive",
            "city": "Waynesboro",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384853848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waynesboro, TN

Sources for this page

Verify at the official NPI Registry.