Active NPI
Kimberly D Walker, CRNA
- Certified Registered Nurse Anesthetist
- Greenwood, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2508
- Practice address
- 1325 Spring St
Greenwood, SC 29646-3860 - Phone
- (864) 725-4111
- NPI assigned
- Jan 18, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2508 | SC | Primary |
| Certified Registered Nurse Anesthetist | 367500000X | 43827 | SC |
Addresses
Primary practice location
1325 Spring St
Greenwood, SC 29646-3860
Mailing address
PO Box 819
Greenwood, SC 29648-0819
Phone (864) 227-8242
Other practice location 1
1325 Spring St
Anesthesia Dept
Greenwood, SC 29646-3860
Phone (864) 227-4111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AN1371 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050214000376 | SC | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5890747349 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Medical College of Georgia School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Self Medical Group
Practice addresses (Care Compare)
1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111
Hospital & facility affiliations
- Self Regional Healthcare
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2508 | SC | MD | Occupational Therapy Assistant |
| 43827 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 6764
Chicago, IL 60675
101 Academy Ave
Greenwood, SC 29646
Phone (864) 227-8242
1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111
2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866
Organizations & group practices 6
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.
-
- Diagnostic Radiology Physician
- Greenwood, SC
- NPI 1659839694
-
- Rural Health Clinic/Center
- Saluda, SC
- NPI 1184219214
-
- Neurological Surgery Physician
- Greenwood, SC
- NPI 1902277270
-
- Anesthesiology Physician
- Greenwood, SC
- NPI 1013579259
-
- Gastroenterology Physician
- Greenwood, SC
- NPI 1841047560
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Pain Medicine (Anesthesiology) Physician
- Greenwood, SC
- NPI 1013867498
Hospital
-
- Pain Medicine (Anesthesiology) Physician
- Clinton, SC
- NPI 1720938103
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710460800000",
"number": "1891775748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 819",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296480819",
"telephone_number": "864-227-8242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 SPRING ST",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296463860",
"telephone_number": "864-725-4111"
}
],
"practiceLocations": [
{
"address_1": "1325 Spring St",
"address_2": "Anesthesia Dept",
"address_purpose": "LOCATION",
"city": "Greenwood",
"state": "SC",
"postal_code": "296463860",
"country_code": "US",
"telephone_number": "864-227-4111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "KIMBERLY",
"middle_name": "D",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "2508",
"primary": true
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "43827",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AN1371",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.