Individual provider Active NPI

Derrick W Walker, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1760611529
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01068282A Issued in IN
Practice address
7910 E Washington St
Suite 200
Indianapolis, IN 46219-2890
Phone
(317) 355-7171
Fax
(317) 355-9022
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01068282A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X 11015165A IN

Addresses

Primary practice location

7910 E Washington St
Suite 200
Indianapolis, IN 46219-2890

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890
Phone (317) 355-7199

Other identifiers 2

IdentifierTypeStateIssuer
201060400MedicaidIN
P01157069OtherINRR MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120612000250 IN Practitioner - Family Practice 8224292842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JS Weill Medical College, Cornell University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7910 E Washington St
Suite 200
Indianapolis, IN 46219-5563
Phone (317) 355-7171

Hospital & facility affiliations

  • Community Health at Home LLC Home health agency, Indianapolis, IN, CCN 157046
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11015165AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jul 1, 2012 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7910 E Washington St
Ste 200
Indianapolis, IN 46219
Phone (317) 355-7171

Interoperability endpoints

  • Direct secure messaging: dwalker11804@ecommunitydirect.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1760611529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-355-7199",
            "fax_number": "317-355-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 E WASHINGTON ST",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192890",
            "telephone_number": "317-355-7171",
            "fax_number": "317-355-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DERRICK",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01068282A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11015165A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201060400",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01157069",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.