Individual provider Active NPI

Reagan Lyndsey Walker, FNP-C

  • Family Nurse Practitioner
  • Cleveland, MS
National Provider Identifier
1285357293
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905588 Issued in MS
Practice address
609 N Davis Ave Ste 105
Cleveland, MS 38732-2379
Phone
(662) 579-3958
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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 905588 MS Primary

Addresses

Primary practice location

609 N Davis Ave Ste 105
Cleveland, MS 38732-2379

Mailing address

PO Box 1178
Itta Bena, MS 38941-0900
Phone (662) 588-1856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20221018000088 MS Practitioner - Nurse Practitioner 1355717208 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Sunflower Medical CenterGroup PAC ID 7618932294, shared by 11 NPIs, 46 clinicians

Practice addresses (Care Compare)

840 N Oak Ave
Ruleville, MS 38771-3227
Phone (601) 756-2711

Hospital & facility affiliations

  • North Sunflower Medical Center Cah Hospital, Ruleville, MS, CCN 251318
  • Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Express Care of Cleveland, LLC CurrentSince Oct 1, 2022 Accepting new patients
North Sunflower Medical Center Current Accepting new patients
North Sunflower Medical Center CurrentSince Oct 21, 2024 Accepting new patients
North Sunflower Medical Center CurrentSince Sep 27, 2024 Accepting new patients
North Sunflower Medical Center CurrentSince Sep 27, 2024 Accepting new patients
North Sunflower Medical Center Current Accepting new patients

Locations

609 N Davis Ave
Ste 105
Cleveland, MS 38732
Phone (662) 579-3958

1515 University Ave
Oxford, MS 38655
Phone (662) 238-0011

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • Direct secure messaging: reagan.walker.1@19209.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1285357293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1178",
            "city": "ITTA BENA",
            "state": "MS",
            "postal_code": "389410900",
            "telephone_number": "662-588-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 N DAVIS AVE STE 105",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322379",
            "telephone_number": "662-579-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "REAGAN",
        "middle_name": "LYNDSEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.