Holly Dawn Walker, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12013 Issued in TN

Practice address

1508 Tombras Ave
East Ridge, TN 37412-2720

Phone

(423) 867-4969

Fax

(423) 867-4971

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EEIHBD
• Direct secure messaging: hwalker171131@direct.stlukeshealth.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.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545

  TN

  Medicare reassignment Care Compare group NPD
• Advanced Diagnostic Imaging, PC

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  TN

  Medicare reassignment NPD
• Cleveland Medical Associates, PLLC

  • Internal Medicine Physician
  • Cleveland, TN
  • NPI 1093723330

  TN

  Medicare reassignment NPD
• Dunlap Medical Center, PLLC

  • Family Medicine Physician
  • Dunlap, TN
  • NPI 1962591982

  TN

  Medicare reassignment NPD
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780
  Care Compare group NPD
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • Dayton, TN
  • NPI 1144633397
  Care Compare group
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • Spring City, TN
  • NPI 1477846954
  Care Compare group
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • Trenton, GA
  • NPI 1467602482
  Care Compare group
• Advanced Diagnostic Imaging PC

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1295763316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 TOMBRAS AVE",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374122720",
            "telephone_number": "423-867-4969",
            "fax_number": "423-867-4971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 Dodds Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374043909",
            "country_code": "US",
            "telephone_number": "423-698-3423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "HOLLY",
        "middle_name": "DAWN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - TENNESSEE",
            "identifier": "4307476",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527678",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Darlene Waldron, RPH
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreens
• Paul Douglas Wentland, M.D.
• Saundra Annette Williams, MD
• Your Good Health, LLC

• All providers in East Ridge, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.