Individual provider Active NPI

Chiquita Kawanda Lynn-Walker, ARNP

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1306307046
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11001898 Issued in FL
Practice address
2827 12TH Ave S
St Petersburg, FL 33712-1903
Phone
(727) 643-2094
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 APRN11001898 FL Primary

Addresses

Primary practice location

2827 12TH Ave S
St Petersburg, FL 33712-1903

Mailing address

2827 12TH Ave S
St Petersburg, FL 33712-1903
Phone (727) 643-2094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201201000844 FL Practitioner - Nurse Practitioner 7113338831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Horizon Medical Clinic LLCGroup PAC ID 7810286960, 4 clinicians

Practice addresses (Care Compare)

5101 E Busch Blvd
Suite 11
Tampa, FL 33617-5380
Phone (813) 899-9797

Hospital & facility affiliations

  • Best Care Home Health at Pasco and Pinellas LLC Home health agency, Wesley Chapel, FL, CCN 687092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Horizon Medical Clinic L.L.C. CurrentSince Oct 2, 2020 Accepting new patients

Locations

5101 E Busch Blvd
Ste 11
Temple Terrace, FL 33617
Phone (813) 615-7625

Organizations & group practices 1

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 1

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1306307046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 12TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337121903",
            "telephone_number": "727-643-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 12TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337121903",
            "telephone_number": "727-643-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN-WALKER",
        "first_name": "CHIQUITA",
        "middle_name": "KAWANDA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.