Carly Diane Walker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2021004154 Issued in MO

Practice address

611 N Central Ave
Eureka, MO 63025-1232

Phone

(636) 579-2882

NPI assigned

Apr 20, 2020

Last updated

May 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105

Merit-based Incentive Payment System (MIPS)

Final score

84.94 of 100Reported as group

Quality

68.52

Promoting interoperability

100

Improvement activities

40

Cost

72.22

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwalker410130@direct-ehr-ssmhc.com

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.

• SSM Health Care Group

  dba SLUCare Physician Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544
  Medicare reassignment Care Compare group NPD
• SLH Physicians LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1881668051
  Medicare reassignment
• SSM Health Care Group

  dba SLUCare Physician Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• SSM Medical Group Inc.

  dba SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Fenton, MO
  • NPI 1124579966
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM-Sluh Inc

  dba SSM Health Saint Louis University Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1447870431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 VESPER DR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112213",
            "telephone_number": "636-579-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N CENTRAL AVE",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251232",
            "telephone_number": "636-579-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CARLY",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021004154",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Velicer, LPC
• Vision Corp Inc
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0295)
• Wal-Mart Stores East, LP (Vision Center 30-0295)
• Walgreen Co (Walgreens #02227)
• Serena Lisa Walker, PHARM D
• Bonnie Waller
• Fawn Noel Weber, LPC
• Christina Whatley
• Nicholas B Wildman, PT, DPT

• Physician Assistant in Eureka, MO
• Providers in Eureka, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.
• 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.