Individual provider Active NPI

Kathryn Heasley Walker, APRN

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1710462148
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22280 Issued in SC
Practice address
124 Mallard St
Greenville, SC 29601-4046
Phone
(864) 241-1040
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22280 SC Primary
Family Nurse Practitioner 363LF0000X 22280 SC

Addresses

Primary practice location

124 Mallard St
Greenville, SC 29601-4046

Mailing address

124 Mallard St
Greenville, SC 29601-4046

Other practice location 1

3093 S Highway 14 Ste 101
Greer, SC 29650-4829
Phone (864) 720-1900

Other identifiers 1

IdentifierTypeStateIssuer
301100MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20190301002304 SC Practitioner - Nurse Practitioner 0345589768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

3093 S Hwy 14
Suite 101
Greer, SC 29650-4829
Phone (864) 720-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22280SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 1, 2025 Accepting new patients
Musc Affiliate Physicians CurrentSince Oct 1, 2021 Accepting new patients
Musc Affiliate Physicians CurrentSince Oct 1, 2021 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

525 Verdae Blvd
Ste 150
Greenville, SC 29607
Phone (864) 516-1783

525 Verdae Blvd
#200
Greenville, SC 29607
Phone (864) 603-5600

124 Mallard St
Greenville, SC 29601
Phone (864) 241-1040

145 E Poinsett St
Greer, SC 29651
Phone 86460356003222

3093 S Highway 14
Ste 101
Greer, SC 29650
Phone (864) 720-1900

Interoperability endpoints

  • Direct secure messaging: kwalker848482@direct.ghs.myhfn.org

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1710462148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3093 S Highway 14 Ste 101",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296504829",
            "country_code": "US",
            "telephone_number": "864-720-1900",
            "fax_number": "864-720-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KATHRYN",
        "middle_name": "HEASLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "22280",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301100",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.