Individual provider Active NPI

Jennifer A Walker, PA

  • Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1366472961
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2240 Issued in AZ
Practice address
1485 N Turquoise Dr Ste 200
Flagstaff, AZ 86001-2000
Phone
(928) 774-7757
Fax
(928) 774-7767
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2240 AZ Primary

Addresses

Primary practice location

1485 N Turquoise Dr Ste 200
Flagstaff, AZ 86001-2000

Mailing address

1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001-2000
Phone (270) 753-5073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20210809001708 UT Practitioner - Physician Assistant 3779554886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123

1380 E Medical Ctr Dr
Suite 1400
St George, UT 84790-2127
Phone (435) 251-2600

652 S Medical Ctr Dr
St George, UT 84790-7049

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2240AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Aug 30, 2021 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 30, 2021 Accepting new patients
Flagstaff Medical Center Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

652 S Medical Center Dr
Ste 400
St George, UT 84790
Phone (435) 251-2650

652 S Medical Center Dr
Ste 120
St George, UT 84790
Phone (435) 251-3600

Organizations & group practices 5

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366472961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DR",
            "address_2": "STE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012000",
            "telephone_number": "270-753-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DR STE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012000",
            "telephone_number": "928-774-7757",
            "fax_number": "928-774-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.