Individual provider Active NPI

Courtney Nicole Walker, DO

  • Gastroenterology Physician
  • Bend, OR
National Provider Identifier
1154684504
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DO192550 Issued in OR
Practice address
2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone
(541) 706-4220
Fax
(541) 597-5819
NPI assigned
Jun 20, 2012
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D.0070050 CO
Gastroenterology Physician 207RG0100X DO192550 OR Primary

Addresses

Primary practice location

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279

Mailing address

PO Box 670
Bend, OR 97709-0670
Phone (541) 706-5777

Other practice location 1

30 N 1900 E
Room 4R118
Salt Lake City, UT 84132-0002
Phone (801) 581-7803

Other practice location 2

1303 NE Cushing Dr Ste 100
Bend, OR 97701-3887
Phone (541) 706-5777

Other practice location 3

2535 S Downing St Ste 410
Denver, CO 80210-5851
Phone (303) 260-2740

Other practice location 4

1303 NE Cushing Dr Ste 100
Bend, OR 97701-3887
Phone (541) 706-5777

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwalker96635@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190827001520 OR Practitioner - GastroenterologyPractitioner - Internal Medicine 1557686094 Reassigns benefits to 1 organization
I20220708001547 TX Practitioner - Gastroenterology 1557686094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

2200 NE Neff Rd
Bend, OR 97701-4283
Phone (541) 382-4321

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy96
Upper gastrointestinal (GI) endoscopy for acid reflux535

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D.0070050COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Family Medicine CurrentSince Aug 12, 2024 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 28, 2022 Accepting new patients
St. Charles Health System, Inc. CurrentSince Aug 12, 2024 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

3900 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1128

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

29358 Network Pl
Chicago, IL 60673

1303 NE Cushing Dr
Ste 100
Bend, OR 97701
Phone (541) 388-2333

2200 NE Neff Rd
Bend, OR 97701
Phone (541) 322-2395

2200 NE Neff Rd
Ste 302
Bend, OR 97701
Phone (541) 706-4220

1245 NW 4th St
Ste 101
Redmond, OR 97756

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: cwalker96635@secure.stcharleshealthcare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1154684504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977090670",
            "telephone_number": "541-706-5777",
            "fax_number": "541-429-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 302",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014279",
            "telephone_number": "541-706-4220",
            "fax_number": "541-597-5819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E",
            "address_2": "ROOM 4R118",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-581-7803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1303 NE Cushing Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977013887",
            "country_code": "US",
            "telephone_number": "541-706-5777",
            "fax_number": "541-429-6642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2535 S Downing St Ste 410",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802105851",
            "country_code": "US",
            "telephone_number": "303-260-2740",
            "fax_number": "303-260-2741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1303 NE Cushing Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977013887",
            "country_code": "US",
            "telephone_number": "541-706-5777",
            "fax_number": "541-429-6642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "D.0070050",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "DO192550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwalker96635@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 302",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.