Individual provider Active NPI

Michelle Cornwell Walker, CRNA

  • Certified Registered Nurse Anesthetist
  • North Wilkesboro, NC
National Provider Identifier
1417955931
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
181094 Issued in NC
Practice address
1370 W D St
North Wilkesboro, NC 28659-3506
Phone
(336) 651-8500
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 181094 NC Primary

Addresses

Primary practice location

1370 W D St
North Wilkesboro, NC 28659-3506

Mailing address

424 Creekstone Dr
Banner Elk, NC 28604-7047
Phone (828) 963-2824

Other identifiers 1

IdentifierTypeStateIssuer
8051672MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070801000557 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193816460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rush Medical College of Rush University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Medical Center IncGroup PAC ID 2668377474, 95 clinicians

Practice addresses (Care Compare)

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4133

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
181094NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 22, 2017 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Watauga Medical Center Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2009 Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Nov 22, 2017 Accepting new patients
Watauga Medical Center Inc CurrentSince Aug 3, 2009 Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
WRMC Hospital Operating Corporation Past Accepting new patients

Locations

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

338 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

Organizations & group practices 8

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1417955931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CREEKSTONE DR",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286047047",
            "telephone_number": "828-963-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "336-651-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MICHELLE",
        "middle_name": "CORNWELL",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "181094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051672",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.