Lillie Marque Walker, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0005644 Issued in MD

Practice address

3460 Old Washington Rd
Suite 300
Waldorf, MD 20602-3240

Phone

(301) 645-1523

Fax

(301) 645-6812

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lillie Marque Stovall Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Center for Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Hagerstown, MD
  • NPI 1962463265
  Medicare reassignment NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1629147632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "EXECUTIVE PLAZA 1, SUITE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "301-645-1523",
            "fax_number": "301-645-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD",
            "address_2": "SUITE 300",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023240",
            "telephone_number": "301-645-1523",
            "fax_number": "301-645-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LILLIE",
        "middle_name": "MARQUE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLIE",
            "last_name": "STOVALL",
            "middle_name": "MARQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co.
• Walgreen Co.
• Giovanna Walker
• Heather Walker, CPM
• James Gibbons Walker, LCSW-C, ACSW
• Natalie Juanita Walker, LCSW-C
• Sydney Walker
• Brandy Walko
• Brooke Walko
• Teonna L Wallop, LCPC

• Medical Physician Assistant in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.

Verify at the official NPI Registry.