Individual provider Active NPI

Kimberly C Walker, MD

  • Child & Adolescent Psychiatry Physician
  • Columbia, MD
National Provider Identifier
1306024930
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D0073253 Issued in MD
Practice address
10630 Little Patuxent Pkwy Ste 313
Columbia, MD 21044-6216
Phone
(240) 334-7650
Fax
(866) 700-7059
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X D0073253 MD Primary
Adult Mental Health Clinic/Center 261QM0850X D0073253 MD

Addresses

Primary practice location

10630 Little Patuxent Pkwy Ste 313
Columbia, MD 21044-6216

Mailing address

5325 Woodlot Rd
Columbia, MD 21044-5721
Phone (717) 497-4418

Other practice location 1

1421 S Caton Ave Ste 201
Baltimore, MD 21227-1025
Phone (443) 873-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0073253MDMDAdult Mental Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Partners, LLC CurrentSince Dec 22, 2020 Accepting new patients
Kimberly C. Walker, M.D. Adult Mental Health CurrentSince Mar 29, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10630 Little Patuxent Pkwy
Ste 313
Columbia, MD 21044
Phone (240) 334-7650

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1306024930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 WOODLOT RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210445721",
            "telephone_number": "717-497-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PKWY STE 313",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446216",
            "telephone_number": "240-334-7650",
            "fax_number": "866-700-7059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 S Caton Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212271025",
            "country_code": "US",
            "telephone_number": "443-873-2520",
            "fax_number": "410-646-2549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0073253",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MD",
            "license": "D0073253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.