Individual provider Active NPI

Valerie A Walker- Clark, OD

  • Optometrist
  • Windsor Mill, MD
National Provider Identifier
1457429854
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1294 Issued in MD
Practice address
7141 Security Blvd
Windsor Mill, MD 21244
Phone
(443) 663-6340
Fax
(443) 663-6352
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1294 MD Primary

Addresses

Primary practice location

7141 Security Blvd
Windsor Mill, MD 21244

Mailing address

2101 East Jefferson Street
Ppqa Medicare Compliance Unit 6 West
Rockville, MD 20852-4908
Phone (301) 816-6660

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100223000042 DC Practitioner - Optometry 2567506082 Reassigns benefits to 1 organization
I20120413000208 MD Practitioner - Optometry 2567506082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7070 Samuel Morse Dr
Columbia, MD 21046-3424
Phone (410) 309-4600

7141 Security Blvd
Woodlawn Med Ctr
Baltimore, MD 21244-1811
Phone (443) 663-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 19, 2012 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 2, 1997 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 2, 1997 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Optometrist Current Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
#4
Rockville, MD 20852

2101 E Jefferson St
Unit 6
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

7141 Security Blvd
Windsor Mill, MD 21244
Phone (410) 281-6200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1457429854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 EAST JEFFERSON STREET",
            "address_2": "PPQA MEDICARE COMPLIANCE UNIT 6 WEST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7141 SECURITY BLVD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "21244",
            "telephone_number": "443-663-6340",
            "fax_number": "443-663-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER- CLARK",
        "first_name": "VALERIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7141 Security Blvd",
            "city": "Windsor Mill",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

Verify at the official NPI Registry.