NPIMap

Individual provider Active NPI

Jeffery P Walker, PA

  • Medical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1164454260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1904 Issued in CO
Practice address
209 S Nevada Ave
Colorado Springs, CO 80903-1906
Phone
(719) 475-7700
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1904 CO Primary

Addresses

Primary practice location

209 S Nevada Ave
Colorado Springs, CO 80903-1906

Mailing address

209 S Nevada Ave
Colorado Springs, CO 80903-1906
Phone (719) 475-7700

Other identifiers 1

IdentifierTypeStateIssuer
18138772MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051202000024 CO Practitioner - Physician Assistant 2668442369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 E 7TH St
Pueblo, CO 81001-3508
Phone (719) 543-8711

1302 E 5TH St
Pueblo, CO 81001-3754
Phone (719) 543-8711

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

328 Avondale Blvd
Avondale, CO 81022-8700
Phone 7195438718385

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1904COMDPsychologist
953SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Sep 18, 2023 Accepting new patients
Peak Vista Community Health Centers CurrentSince Dec 1, 2025 Accepting new patients
Peak Vista Community Health Centers CurrentSince Dec 1, 2025 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Sep 18, 2023 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients
Pueblo Community Health Center Inc. Past Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

1301 E 7th St
Pueblo, CO 81001
Phone (719) 476-0220

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Interoperability endpoints

  • Direct secure messaging: jeffery.walker.p1@direct.pueblochc.nextgenshare.com

Organizations & group practices 7

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 7

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164454260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031906",
            "telephone_number": "719-475-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031906",
            "telephone_number": "719-475-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JEFFERY",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18138772",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.