Individual provider Active NPI

D'Andra Mixon-Walker, PA-C

  • Physician Assistant
  • Summit, IL
National Provider Identifier
1285375188
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7450 W 63Rd St
Summit, IL 60501-1816
Phone
(708) 458-0757
NPI assigned
Apr 5, 2022
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7450 W 63Rd St
Summit, IL 60501-1816

Mailing address

1724 E 36TH Ave
Denver, CO 80205-4033
Phone (720) 327-0122

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dandra.mixonwalker@achn.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230117002429 IL Practitioner - Physician Assistant 7618348350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

3202 W N Ave
Humboldt Family Health Center
Chicago, IL 60647-4940
Phone (773) 278-1880

6020 W Diversey Ave
BLDG West
Chicago, IL 60639-1108
Phone (773) 237-5544

7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Dec 12, 2022 Accepting new patients
Access Community Health Network CurrentSince Dec 12, 2022 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

3202 W North Ave
Chicago, IL 60647
Phone (773) 278-1880

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

6020 W Diversey Ave
Bldg W
Chicago, IL 60639
Phone (773) 237-5544

7450 W 63rd St
Summit Argo, IL 60501
Phone (708) 458-0757

Interoperability endpoints

  • Direct secure messaging: dandra.mixonwalker@achn.net
  • Direct secure messaging: dmixonwalker20637@direct.achn.net

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1285375188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 E 36TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802054033",
            "telephone_number": "720-327-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 W 63RD ST",
            "city": "SUMMIT",
            "state": "IL",
            "postal_code": "605011816",
            "telephone_number": "708-458-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXON-WALKER",
        "first_name": "D'ANDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dandra.mixonwalker@achn.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "7450 W 63rd St",
            "city": "Summit",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605011816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summit, IL

Sources for this page

Verify at the official NPI Registry.