NPIMap

Individual provider Active NPI

Justin James Walker, M.D.

  • Family Medicine Physician
  • Evans, CO
National Provider Identifier
1871799726
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47057 Issued in CO
Practice address
2930 11TH Ave
Evans, CO 80620-1011
Phone
(970) 353-9403
Fax
(970) 353-9906
NPI assigned
Jun 26, 2007
Last updated
May 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47057 CO Primary

Addresses

Primary practice location

2930 11TH Ave
Evans, CO 80620-1011

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

Other identifiers 1

IdentifierTypeStateIssuer
50001884MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000653 CO Practitioner - Family Practice 5698955912 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

100 N 11TH Ave
Greeley, CO 80631-2011
Phone (970) 352-8898

1010 A St
Greeley, CO 80631-2021
Phone (970) 313-0400

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

302 3Rd St SE
Suite 150
Loveland, CO 80537-6419
Phone (970) 669-4855

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47057COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Colorado Family Medicine CurrentSince Nov 9, 2015 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Jul 1, 2014 Accepting new patients
Sunrise Community Health CurrentSince Oct 24, 2010 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Jul 1, 2014 Accepting new patients
Sunrise Community Health CurrentSince Oct 24, 2010 Accepting new patients
Sunrise Community Health Family Medicine Current Accepting new patients
Banner Greeley Specialists Past Accepting new patients
North Colorado Medical Center Past Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

1028 5th Ave
Greeley, CO 80631
Phone (970) 352-8898

1600 23rd Ave
Greeley, CO 80634
Phone (970) 356-2424

1800 15th St
Ste 210
Greeley, CO 80631
Phone (970) 352-8216

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Interoperability endpoints

  • Direct secure messaging: justin.walker.1@27043.direct.athenahealth.com

Organizations & group practices 8

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 12

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1871799726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-353-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-353-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "47057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50001884",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, CO

Sources for this page

Verify at the official NPI Registry.