Individual provider Active NPI

Carla Favaro Walkley, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1396185054
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5014110 Issued in NC
Practice address
2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217-4596
Phone
(855) 438-0010
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 102595 WI
Nurse Practitioner 363L00000X 209031504 IL
Pediatric Nurse Practitioner 363LP0200X 5014110 NC
Primary Care Nurse Practitioner 363LP2300X 5014110 NC
Nurse Practitioner 363L00000X 5014110 NC Primary

Addresses

Primary practice location

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217-4596

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone (262) 693-4312

Other practice location 2

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217-4596
Phone (855) 438-0010

Other identifiers 1

IdentifierTypeStateIssuer
100317173MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address cwalkley438090@direct.myadvocateaurora.org Direct
Direct Messaging Address cwalkley430504@CarolinasHealthcareSystem.direct-ci.com Atrium Health
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, WI, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20240311001358 NC Practitioner - Nurse Practitioner 1254568280 Reassigns benefits to 2 organizations
I20250423002660 IL Practitioner - Nurse Practitioner 1254568280 Reassigns benefits to 1 organization
I20250423002858 WI Practitioner - Nurse Practitioner 1254568280 Reassigns benefits to 1 organization
I20250603001092 GA Practitioner - Nurse Practitioner 1254568280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209031504ILMDNurse Practitioner
102595WIMDNurse Practitioner
5014110NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Mar 2, 2024 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Mar 9, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 9, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 25, 2023 Accepting new patients
Floyd Healthcare Management Inc CurrentSince May 1, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 25, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Floyd Healthcare Management Inc CurrentSince May 1, 2025 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217
Phone (704) 446-9173

3173 W Highway 74
Monroe, NC 28110
Phone (704) 283-2000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
Ste 140
New Berlin, WI 53151
Phone (262) 827-0480

Interoperability endpoints

  • Direct secure messaging: cwalkley430504@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1396185054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 WATER RIDGE PKWY",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174596",
            "telephone_number": "855-438-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Branding Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155624",
            "country_code": "US",
            "telephone_number": "262-693-4312",
            "fax_number": "414-203-3788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2709 Water Ridge Pkwy",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282174596",
            "country_code": "US",
            "telephone_number": "855-438-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKLEY",
        "first_name": "CARLA",
        "middle_name": "FAVARO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "102595",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209031504",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5014110",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5014110",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317173",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwalkley438090@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwalkley430504@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2709 Water Ridge Pkwy",
            "address_2": "Ste 500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282174596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.