William Bradbury Walker, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9100985 Issued in FL

Practice address

1536 N Jefferson St
Jacksonville, FL 32209-6525

Phone

(904) 475-6319

Fax

(904) 475-5809

NPI assigned

Nov 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• First Coast Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1528197993
  NPD (past)

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1427039650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-6319",
            "fax_number": "904-475-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-6319",
            "fax_number": "904-475-5809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1833 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322064382",
            "country_code": "US",
            "telephone_number": "904-232-2751 x2037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1536 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096525",
            "country_code": "US",
            "telephone_number": "904-475-6319",
            "fax_number": "904-475-5809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "WILLIAM",
        "middle_name": "BRADBURY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9100985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970010568",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toilicia Danielle Sylvia Walker
• Trinity Janae Walker
• Tynesha Walker
• Veronica Walker
• Vickey Cassandra Walker
• Megan Elizabeth Walkowski, DPT
• Annette Faulkner Wall, ARNP
• Dana Lee Wall, OTR
• Roberta Vesta Wall, ARNP
• Tanya C Wall, DDS

• Medical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.