Individual provider Active NPI

Jennifer E Walker, DC

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1649200130
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556935 Issued in VA
Practice address
2522 Colonial Ave SW
Roanoke, VA 24015-3121
Phone
(540) 343-0055
Fax
(540) 627-5055
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556935 VA Primary

Addresses

Primary practice location

2522 Colonial Ave SW
Roanoke, VA 24015-3121

Mailing address

2110 Carolina Ave SW
Roanoke, VA 24014-1738
Phone (540) 343-0055

Other identifiers 2

IdentifierTypeStateIssuer
P00319591OtherMEDICARE RR
188918OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060227000691 VA Practitioner - Chiropractic 0749296846 Reassigns benefits to 1 organization
I20200403001697 CO Practitioner - Chiropractic 0749296846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balance Wellspace Integrative Medicine IncGroup PAC ID 9638410624, 8 clinicians

Practice addresses (Care Compare)

2522 Colonial Ave SW
Roanoke, VA 24015-3121
Phone (540) 343-0055

2725 Market St
Christiansburg, VA 24073-6514
Phone (540) 585-4077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556935VAMDChiropractor
2677MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Wellspace Integrative Medicine, Inc. CurrentSince Nov 30, 2016 Accepting new patients
Blue Ridge Wound Care LLC PastSince Jan 10, 2024 Accepting new patients
Wound Care Associates of Colorado LLC PastSince Sep 1, 2024 Accepting new patients

Locations

2725 Market St
Christiansburg, VA 24073
Phone (540) 343-0055

2110 Carolina Ave SW
Roanoke, VA 24014
Phone (540) 343-0055

1603 Franklin Rd SW
Roanoke, VA 24016
Phone (540) 343-0055

2522 Colonial Ave SW
Roanoke, VA 24015
Phone (540) 343-0055

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1649200130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 CAROLINA AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141738",
            "telephone_number": "540-343-0055",
            "fax_number": "540-343-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 COLONIAL AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153121",
            "telephone_number": "540-343-0055",
            "fax_number": "540-627-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00319591",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "188918",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.