Individual provider Active NPI

Kimberly Dawn Walker, DNP, RN, CPNP-PC

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1235630039
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3012065 Issued in KY
Practice address
4123 Dutchmans LN Ste 301
Louisville, KY 40207-4721
Phone
(502) 896-2500
NPI assigned
Feb 27, 2018
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3012065 KY Primary

Addresses

Primary practice location

4123 Dutchmans LN Ste 301
Louisville, KY 40207-4721

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180316002148 KY Practitioner - Nurse Practitioner 7416219159 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3012065KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Norton Children's Medical Group, LLC Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Mar 1, 2018 Accepting new patients
Norton Children's Medical Group, LLC Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Mar 1, 2018 Accepting new patients
Norton Childrens Medical Group, LLC Nurse Practitioner Past Accepting new patients

Locations

4123 Dutchmans Ln
Ste 301
Louisville, KY 40207
Phone (502) 896-2500

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

150 Frankfort Rd
Ste 101
Shelbyville, KY 40065
Phone (502) 647-5468

Interoperability endpoints

  • Direct secure messaging: kwalker139970@direct.nortonhealthcare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1235630039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN STE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074721",
            "telephone_number": "502-896-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "DNP, RN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.