Active NPI
Jerald Walker, CSFA
- Surgical Technologist
- Matthews, NC
National Provider Identifier
1730644808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 185417
- Practice address
- 710 Park Center Dr Ste 300
Matthews, NC 28105-5082 - Phone
- (704) 323-3200
- NPI assigned
- Feb 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 185417 | ID | Primary |
Addresses
Primary practice location
710 Park Center Dr Ste 300
Matthews, NC 28105-5082
Mailing address
4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185417 | ID | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1730644808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 PARK CENTER DR STE 300",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281055082",
"telephone_number": "704-323-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JERALD",
"credential": "CSFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-04",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "ID",
"license": "185417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.