Individual provider Active NPI

Sanyu Haffusa Walker, APRN

  • Primary Care Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1740613744
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2297541 Issued in MA
Practice address
3550 Main St. Commonwealth Community Care
Suite 101
Springfield, MA 01107-1078
Phone
(413) 858-7400
Fax
(413) 746-0380
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2297541 MA Primary

Addresses

Primary practice location

3550 Main St. Commonwealth Community Care
Suite 101
Springfield, MA 01107-1078

Mailing address

1 Boston Medical Ctr PL
Dowling North, Suite 5108
Boston, MA 02118-2908
Phone (617) 638-7062

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2297541MAMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1740613744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "address_2": "DOWLING NORTH, SUITE 5108",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-638-7062",
            "fax_number": "617-638-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MAIN ST. COMMONWEALTH COMMUNITY CARE",
            "address_2": "SUITE 101",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071078",
            "telephone_number": "413-858-7400",
            "fax_number": "413-746-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SANYU",
        "middle_name": "HAFFUSA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "2297541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.