Active NPI
Donald Edward Walker Jr., M.D.
- Psychiatry Physician
- Kansas City, MO
National Provider Identifier
1306864079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R9358
- Practice address
- 4400 Broadway
Suite 407
Kansas City, MO 64111-5941 - Phone
- (816) 932-1711
- Fax
- (816) 932-1719
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R9358 | MO | Primary |
Addresses
Primary practice location
4400 Broadway
Suite 407
Kansas City, MO 64111-5941
Mailing address
4400 Broadway St
Suite 407
Kansas City, MO 64111-3498
Phone (816) 932-1711
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10641051 | Other | MO | BC/BS OF KC |
| P00445189 | Other | MO | RAILROAD |
| 204792808 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061211000410 | MO | Practitioner - Psychiatry | 0244239739 | Practice locations: Kansas City, MO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9358 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Hospital of Kansas City | Psychiatry | Past | Accepting new patients |
| St Lukes Hospital of Kansas City | Past | Accepting new patients |
Interoperability endpoints
- https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4
Organizations & group practices 2
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.
-
- Specialty Pharmacy
- Kansas City, MO
- NPI 1588457923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334275200000",
"number": "1306864079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 BROADWAY ST",
"address_2": "SUITE 407",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641113498",
"telephone_number": "816-932-1711",
"fax_number": "816-932-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 BROADWAY",
"address_2": "SUITE 407",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641115941",
"telephone_number": "816-932-1711",
"fax_number": "816-932-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DONALD",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2012-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "R9358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF KC",
"identifier": "10641051",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00445189",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204792808",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.