Active NPI
Brandon Rose Walker, MS
- Speech-Language Pathologist
- Jackson, MS
National Provider Identifier
1346080447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 622-0052
- NPI assigned
- May 28, 2024
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | MS | Primary |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
4883 W Madison St
Flora, MS 39071-9389
Phone (601) 622-0052
Other practice location 1
4883 W Madison St
Flora, MS 39071-9389
Phone (601) 622-0052
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
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients |
Locations
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
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.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1346080447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4883 W MADISON ST",
"city": "FLORA",
"state": "MS",
"postal_code": "390719389",
"telephone_number": "601-622-0052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-622-0052"
}
],
"practiceLocations": [
{
"address_1": "4883 W Madison St",
"address_purpose": "LOCATION",
"city": "Flora",
"state": "MS",
"postal_code": "390719389",
"country_code": "US",
"telephone_number": "601-622-0052",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "BRANDON",
"middle_name": "ROSE",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-28",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.