Individual provider Active NPI

Roslyn Miller Walker, MA, LPA

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1427073618
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1526 Issued in NC
Practice address
1931 J N Pease PL Ste 204
Charlotte, NC 28262-4543
Phone
(704) 717-2800
Fax
(704) 717-6200
NPI assigned
Jul 12, 2006
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1526 NC Primary

Addresses

Primary practice location

1931 J N Pease PL Ste 204
Charlotte, NC 28262-4543

Mailing address

1931 J N Pease PL Ste 204
Charlotte, NC 28262-4543
Phone (704) 717-2800

Other identifiers 2

IdentifierTypeStateIssuer
6107329MedicaidNC
144PEOtherNCBLUE CROSS BLUE SHIED

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)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Peace Counseling Services, PLLC CurrentSince Dec 22, 2019 Accepting new patients
Piedmont Performance Evaluations, PLLC Past Accepting new patients

Locations

1931 J N Pease Pl
Ste 204
Charlotte, NC 28262
Phone (704) 549-3993

Interoperability endpoints

  • Direct secure messaging: roslyn.walker@direct.covenantcms.nchie.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1427073618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 J N PEASE PL STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624543",
            "telephone_number": "704-717-2800",
            "fax_number": "704-717-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 J N PEASE PL STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624543",
            "telephone_number": "704-717-2800",
            "fax_number": "704-717-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ROSLYN",
        "middle_name": "MILLER",
        "name_prefix": "Mrs.",
        "credential": "MA, LPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107329",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIED",
            "identifier": "144PE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.