Active NPI
Joanna Lynn Walker, D.O.
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1780874180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 12599
- Practice address
- 3945 San Jose Park Dr
Jacksonville, FL 32217-4612 - Phone
- (904) 731-3530
- NPI assigned
- Jul 31, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12599 | FL | Primary |
Addresses
Primary practice location
3945 San Jose Park Dr
Jacksonville, FL 32217-4612
Mailing address
PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032
Other practice location 1
400 Colonnade Dr
Ponte Vedra Beach, FL 32081-6235
Phone (904) 686-7577
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010754300 | Medicaid | FL | |
| 014273000 | Medicaid | FL |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12599 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jwalker160457@baptisthealthsystemjacksonville.direct-ci.com
Organizations & group practices 1
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": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1780874180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746638",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746638",
"telephone_number": "904-202-1032",
"fax_number": "904-376-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3945 SAN JOSE PARK DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174612",
"telephone_number": "904-731-3530"
}
],
"practiceLocations": [
{
"address_1": "400 Colonnade Dr",
"address_purpose": "LOCATION",
"city": "Ponte Vedra Beach",
"state": "FL",
"postal_code": "320816235",
"country_code": "US",
"telephone_number": "904-686-7577",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "JOANNA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "12599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010754300",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014273000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.