NPIMap

Individual provider Active NPI

Jeremy Walker, FNP-C

  • Family Nurse Practitioner
  • Clay, WV
National Provider Identifier
1164970570
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
82794 Issued in WV
Practice address
122 Center St
Clay, WV 25043-7046
Phone
(304) 587-7301
Fax
(304) 587-2464
NPI assigned
Sep 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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 82794 WV Primary

Addresses

Primary practice location

122 Center St
Clay, WV 25043-7046

Mailing address

634 Elk Est
Elkview, WV 25071-9551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20161115000706 WV Practitioner - Nurse Practitioner 7214216282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

1097 Fledderjohn Rd
Suite 1
Charleston, WV 25314-4208
Phone (304) 345-3627

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc CurrentSince Jul 9, 2023 Accepting new patients
GR&W, Inc PastSince Jul 9, 2023 Accepting new patients

Locations

1 Kenton Dr
Charleston, WV 25311
Phone (304) 205-9008

1 Kenton Dr
#200
Charleston, WV 25311
Phone (304) 408-3292

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

1100 Main St
Ste 104
Wheeling, WV 26003
Phone (304) 443-1414

Organizations & group practices 3

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1164970570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 ELK EST",
            "city": "ELKVIEW",
            "state": "WV",
            "postal_code": "250719551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CENTER ST",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "250437046",
            "telephone_number": "304-587-7301",
            "fax_number": "304-587-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "82794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay, WV

Sources for this page

Verify at the official NPI Registry.