Individual provider Active NPI

Susan Wilsey Walker, AGNP-C, MSN, RN

  • Gerontology Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1467143263
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4012116 Issued in KY
Practice address
6000 Poplar Ave Ste 250
Memphis, TN 38119-3974
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
May 15, 2023
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4012116 KY
Gerontology Nurse Practitioner 363LG0600X RN2125312 FL
Gerontology Nurse Practitioner 363LG0600X 34501 TN
Gerontology Nurse Practitioner 363LG0600X 4012116 KY Primary

Addresses

Primary practice location

6000 Poplar Ave Ste 250
Memphis, TN 38119-3974

Mailing address

3063 Sawyer Ridge CT
Jacksonville, FL 32223-1652
Phone (904) 568-5051

Other practice location 1

306 W Main St Ste 512
Frankfort, KY 40601-1840
Phone (574) 546-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231019000083 TN Practitioner - Nurse Practitioner 0941655435 Reassigns benefits to 1 organization
I20231221003643 KY Practitioner - Nurse Practitioner 0941655435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidestar Eldercare - TN, PCGroup PAC ID 8527413517, 20 clinicians

Practice addresses (Care Compare)

6000 Poplar Ave
Suite 250
Memphis, TN 38119-3974
Phone (574) 546-1900

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
34501TNMDPharmacist
4012116KYMDNurse Practitioner
RN2125312FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology and Pain Management Associates PC Nurse Practitioner CurrentSince Nov 21, 2023 Accepting new patients
Guidestar Eldercare - TN, P.C. Nurse Practitioner CurrentSince Sep 25, 2023 Accepting new patients

Locations

306 W Main St
Ste 512
Frankfort, KY 40601
Phone (860) 215-2295

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

6000 Poplar Ave
Ste 250
Memphis, TN 38119
Phone (901) 451-9577

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1467143263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 SAWYER RIDGE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231652",
            "telephone_number": "904-568-5051",
            "fax_number": "904-483-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 POPLAR AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193974",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 W Main St Ste 512",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "KY",
            "postal_code": "406011840",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SUSAN",
        "middle_name": "WILSEY",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4012116",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "RN2125312",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "34501",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "4012116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.