Individual provider Active NPI

Susan N Walkley, NP-C

  • Family Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1164703401
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024169579 Issued in VA
Practice address
5477 Mooretown Rd
Williamsburg, VA 23188-2108
Phone
(757) 565-0106
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024169579 VA Primary

Addresses

Primary practice location

5477 Mooretown Rd
Williamsburg, VA 23188-2108

Mailing address

PO Box 87
Lightfoot, VA 23090-0087
Phone (757) 941-5095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111020000792 VA Practitioner - Nurse Practitioner 5991977761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors of Williamsburg PCGroup PAC ID 2466795604, 10 clinicians

Practice addresses (Care Compare)

5239 Monticello Ave
Suite Bandc
Williamsburg, VA 23188-8242
Phone (757) 279-2999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024169579VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 6, 2018 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 6, 2018 Accepting new patients
Doctors of Williamsburg, PC CurrentSince Oct 11, 2025 Accepting new patients
Velocity Urgent Care, LLC CurrentSince Dec 1, 2017 Accepting new patients

Locations

827 Diligence Dr
Ste 100
Newport News, VA 23606

13347 Warwick Blvd
Newport News, VA 23602
Phone (757) 877-0214

4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124

4374 New Town Ave
Ste 100
Williamsburg, VA 23188
Phone (757) 259-1900

5239 Monticello Ave
Ste Bc
Williamsburg, VA 23188
Phone (757) 279-2999

5483 Mooretown Rd
Williamsburg, VA 23188
Phone (757) 767-5111

4125 Ironbound Rd
Ste 200
Williamsburg, VA 23188
Phone (757) 345-2829

Interoperability endpoints

  • Direct secure messaging: susan.walkley.1@17374.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1164703401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "LIGHTFOOT",
            "state": "VA",
            "postal_code": "230900087",
            "telephone_number": "757-941-5095",
            "fax_number": "757-565-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5477 MOORETOWN RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882108",
            "telephone_number": "757-565-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKLEY",
        "first_name": "SUSAN",
        "middle_name": "N",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.