Individual provider Active NPI

Joseph D. Walker, PA-C

  • Physician Assistant
  • Blanding, UT
National Provider Identifier
1720477508
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0312 Issued in NV
Practice address
910 S 300 W
Blanding, UT 84511-3921
Phone
(435) 678-3601
NPI assigned
Jan 15, 2015
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1589 NV
Physician Assistant 363A00000X PA0312 NV Primary

Addresses

Primary practice location

910 S 300 W
Blanding, UT 84511-3921

Mailing address

PO Box 130
Montezuma Creek, UT 84534-0130
Phone (435) 651-3700

Other practice location 1

4475 S Eastern Ave
Las Vegas, NV 89119-7826
Phone (702) 737-1880

Other identifiers 1

IdentifierTypeStateIssuer
1720477508MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150227002123 NV Practitioner - Physician Assistant 6507182052 Reassigns benefits to 1 organization
I20180222001216 UT Practitioner - Physician Assistant 6507182052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Rainbow Rd
Navajo Mountain, UT 84511-3910
Phone (928) 672-2498

30 W Medical Dr
Monument Valley, UT 84536-0005
Phone (435) 727-3000

802 S 200
Blanding, UT 84511-3910
Phone (435) 678-3601

East Hwy 262
Montezuma Creek, UT 84534-0130
Phone (435) 651-3700

PO Box
Montezuma Creek, UT 84534-0130

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0312NVMDPhysician Assistant
PA1589NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Feb 23, 2015 Accepting new patients
Utah Navajo Health System, Incorporated CurrentSince Jan 20, 2018 Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients

Locations

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

4475 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 669-5811

910 S 300 W
Blanding, UT 84511
Phone (435) 678-0700

Interoperability endpoints

  • Direct secure messaging: joseph.walker.1@16098.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1720477508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-651-3700",
            "fax_number": "435-678-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S 300 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113921",
            "telephone_number": "435-678-3601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4475 S Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891197826",
            "country_code": "US",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-2458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JOSEPH",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1589",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720477508",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanding, UT

Sources for this page

Verify at the official NPI Registry.