Individual provider Active NPI

Rebecca Hutt Walker, D.O.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1336116193
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO1320 Issued in TN
Practice address
6263 Poplar Ave
Memphis, TN 38119-4701
Phone
(901) 761-6157
NPI assigned
Mar 1, 2006
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO1320 TN Primary

Addresses

Primary practice location

6263 Poplar Ave
Memphis, TN 38119-4701

Mailing address

PO Box 381587
Germantown, TN 38183-1587
Phone (901) 761-6157

Other identifiers 2

IdentifierTypeStateIssuer
3306297MedicaidTN
3158460OtherTNBCBST

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000441 TN Practitioner - Internal Medicine 1557360641 Practice locations: Germantown, TN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1320TNMDInternal Medicine Physician
1320TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Long Primary Care, PLLC Internal Medicine Past Accepting new patients
T M Carr MD PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1336116193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381587",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831587",
            "telephone_number": "901-761-6157",
            "fax_number": "901-761-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6263 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194701",
            "telephone_number": "901-761-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "REBECCA",
        "middle_name": "HUTT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO1320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3306297",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "3158460",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.