NPIMap

Individual provider Active NPI

Kevin Bradford Walker, PA-C

  • Physician Assistant
  • Kernersville, NC
National Provider Identifier
1639319676
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01751 Issued in NC
Practice address
794 S Main St Ste B
Kernersville, NC 27284-4074
Phone
(336) 904-2317
Fax
(336) 443-6030
NPI assigned
Mar 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01751 NC Primary

Addresses

Primary practice location

794 S Main St Ste B
Kernersville, NC 27284-4074

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

601 N Elm St
High Point, NC 27262-4331
Phone (910) 620-5491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090822000149 NC Practitioner - Physician Assistant 8527012210 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

1319 New Garden Rd
Greensboro, NC 27410-2722
Phone (336) 716-9622

2005 Pisgah Church Rd
Greensboro, NC 27455-3309
Phone (336) 701-2662

3120 Northline Ave
Greensboro, NC 27408-7814

50 Miller St
Suite C
Winston Salem, NC 27104-4206
Phone (336) 310-5535

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CDT Healthcare CurrentSince Nov 1, 2018 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 28, 2022 Accepting new patients
Wake Forest University Health Sciences CurrentSince Aug 15, 2024 Accepting new patients
Carolina Medicorp Enterprises LLC CurrentSince Oct 28, 2022 Accepting new patients
Henderson Emergency Physicians, PLLC Past Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

794 S Main St
Ste B
Kernersville, NC 27284
Phone (336) 904-2317

101 Walmart Supercenter
Siler City, NC 27344
Phone (919) 663-3911

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: kwalker452365@direct.novanthealth.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1639319676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 S MAIN ST STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272844074",
            "telephone_number": "336-904-2317",
            "fax_number": "336-443-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Elm St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624331",
            "country_code": "US",
            "telephone_number": "910-620-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KEVIN",
        "middle_name": "BRADFORD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.