Active NPI
Jessica Vavra Walker, M.D.
- Plastic Surgery Physician
- Lexington, KY
National Provider Identifier
1467892729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 65046
- Practice address
- 740 South Limestone
Lexington, KY 40508 - Phone
- (859) 257-8344
- NPI assigned
- Jul 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 50921 | KY | |
| Surgery of the Hand (Plastic Surgery) Physician | 2082S0105X | 50921 | KY | |
| Surgery Physician | 208600000X | L2492966 | MI | |
| Plastic Surgery Physician | 208200000X | 65046 | TN | Primary |
Addresses
Primary practice location
740 South Limestone
Lexington, KY 40508
Mailing address
109 S Northshore Dr Ste 101
Knoxville, TN 37919-4925
Phone (865) 450-9253
Other names 1
- Jessica Marie Vavra
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160718002191 | MI | Order and Referring Only - General Surgery | 5496048100 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50921 | KY | MD | Plastic Surgery Physician |
| 65046 | TN | MD | Plastic Surgery Physician |
| L2492966 | MI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1467892729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 S NORTHSHORE DR STE 101",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194925",
"telephone_number": "865-450-9253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 SOUTH LIMESTONE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40508",
"telephone_number": "859-257-8344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JESSICA",
"middle_name": "VAVRA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-01",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "KY",
"license": "50921",
"primary": false
},
{
"code": "2082S0105X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Surgery of the Hand",
"state": "KY",
"license": "50921",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "L2492966",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TN",
"license": "65046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "VAVRA",
"middle_name": "MARIE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.