Individual provider Active NPI

Evelyn Ricks Walker, MD

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1538339932
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11432 Issued in MS
Practice address
350 W Woodrow Wilson Ave
Jackson, MS 39213-7681
Phone
(601) 979-8754
Fax
(601) 979-8755
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11432 MS Primary

Addresses

Primary practice location

350 W Woodrow Wilson Ave
Jackson, MS 39213-7681

Mailing address

350 W Woodrow Wilson Ave
Jackson, MS 39213-7681
Phone (601) 979-8754

Other identifiers 1

IdentifierTypeStateIssuer
11432OtherMSLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000511 MS Practitioner - Family Practice 2365514775 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 15, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Nov 15, 2018 Accepting new patients
Delta Medical Group Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

350 W Woodrow Wilson Ave
Jackson, MS 39213
Phone (601) 364-2666

878 Lakeland Dr
Jackson, MS 39216
Phone (601) 984-6800

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1538339932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-979-8754",
            "fax_number": "601-979-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-979-8754",
            "fax_number": "601-979-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "EVELYN",
        "middle_name": "RICKS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "11432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "11432",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.