Active NPI
Rosalyn C Walker, M.D.
- Pediatric Pulmonology Physician
- Jackson, MS
National Provider Identifier
1316983620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 11433
- Practice address
- 570 E Woodrow Wilson Ave
Jackson, MS 39216-4538 - Phone
- (601) 576-7472
- Fax
- (601) 576-7825
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 11433 | MS | Primary |
Addresses
Primary practice location
570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Mailing address
570 E Woodrow Wilson Ave
Jackson, MS 39216-4538
Phone (601) 576-7472
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00116555 | Medicaid | MS | |
| 1677728 | Medicaid | LA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11433 | MS | MD | Pediatric Pulmonology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1316983620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 E WOODROW WILSON AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164538",
"telephone_number": "601-576-7472",
"fax_number": "601-576-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 E WOODROW WILSON AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164538",
"telephone_number": "601-576-7472",
"fax_number": "601-576-7825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "ROSALYN",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "MS",
"license": "11433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00116555",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1677728",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.