Individual provider Active NPI

Jonathan Walton Walker, FNP

  • Nurse Practitioner
  • King, NC
National Provider Identifier
1508417114
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012312 Issued in NC
Practice address
216 Moore Rd
King, NC 27021-8703
Phone
(336) 983-4346
Fax
(336) 985-5101
NPI assigned
Sep 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012312 NC Primary

Addresses

Primary practice location

216 Moore Rd
King, NC 27021-8703

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwalker531070@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20200108000660 NC Practitioner - Nurse Practitioner 8527493113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

100 Robinhood Medical PLZ
Winston Salem, NC 27106-5476
Phone (336) 718-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5012312NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Oct 28, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. Family Medicine CurrentSince Oct 28, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Oct 28, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Oct 28, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc Family Medicine Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

167 Moore Rd
Ste 201
King, NC 27021
Phone (336) 673-6450

216 Moore Rd
King, NC 27021
Phone (336) 768-1270

865 Westlake Dr
Mount Airy, NC 27030
Phone (336) 719-6100

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

Interoperability endpoints

  • Direct secure messaging: jwalker531070@direct.novanthealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1508417114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MOORE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218703",
            "telephone_number": "336-983-4346",
            "fax_number": "336-985-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JONATHAN",
        "middle_name": "WALTON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwalker531070@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "216 Moore Rd",
            "city": "King",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270218703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in King, NC

Sources for this page

Verify at the official NPI Registry.