Individual provider Active NPI

Amy E Walker, ACNP-BC

  • Interventional Pain Medicine Physician
  • Evansville, IN
National Provider Identifier
1962592956
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
71002499A Issued in IN
Practice address
1101 Professional Blvd
Evansville, IN 47714-8016
Phone
(812) 477-7246
Fax
(812) 477-7240
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71002499A IN
Acute Care Nurse Practitioner 363LA2100X 3005053 KY
Nurse Practitioner 363L00000X 71002499A IN
Interventional Pain Medicine Physician 208VP0014X 71002499A IN Primary

Addresses

Primary practice location

1101 Professional Blvd
Evansville, IN 47714-8016

Mailing address

1101 Professional Blvd
Evansville, IN 47714-8016
Phone (812) 477-7246

Other identifiers 1

IdentifierTypeStateIssuer
200890260MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71002499AINMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleanslate Medical Group of Indiana LLC CurrentSince Sep 23, 2019 Accepting new patients
Major Hospital Interventional Pain Medicine Past Accepting new patients
Lee Family Care PLLC PastSince Mar 1, 2020 Accepting new patients
Neurosurgical Consultants LLP Nurse Practitioner PastSince Apr 26, 2003 Accepting new patients
MPS-Cardiology LLC Nurse Practitioner Past Accepting new patients
Jeffrey W. Selby MD PSC Acute Care PastSince Jun 17, 2013 Accepting new patients
Neurosurgical Consultants LLP Nurse Practitioner Past Accepting new patients

Locations

4925 S Scatterfield Rd
#G
Anderson, IN 46013
Phone (765) 442-0402

4925 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 442-0402

4411 Washington Ave
Ste 105
Evansville, IN 47714
Phone (812) 213-0304

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24527/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1962592956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148016",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148016",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "AMY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71002499A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3005053",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002499A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "71002499A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200890260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.