Mallori Walker, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71005771A Issued in IN

Practice address

253 Sagamore Pkwy W
West Lafayette, IN 47906-1501

Phone

(765) 448-8000

Fax

(765) 448-7611

NPI assigned

Jul 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwalke11@direct.iuhealth.org

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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1295110336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061501",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MALLORI",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28180875A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71005771A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000964736",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwalke11@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "253 Sagamore Pkwy W",
            "city": "West Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479061501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wal-Mart Stores East LP
• Katherine Walesky
• Walgreen Co
• Alexis Walker
• Hope Elizabeth Walker
• Rachel Walker
• Sadie Walker
• Wendy C Walker, CPT
• Rachel E Wallace
• Hannah Marie Wallpe

• Pediatric Nurse Practitioner in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.