Active NPI
Brock D Walker, CRNA
- Certified Registered Nurse Anesthetist
- Terre Haute, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 28258298A
- Practice address
- 1606 N 7TH St
Terre Haute, IN 47804-2706 - Phone
- (812) 238-7000
- NPI assigned
- Apr 7, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28258298A | IN | Primary |
Addresses
Primary practice location
1606 N 7TH St
Terre Haute, IN 47804-2706
Mailing address
2103 Hershey Rd
Erie, PA 16509-4515
Phone (208) 221-8221
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28258298A | Other | IN | NURSING LICENSE |
| N-45784 | Other | ID | NURSING LICENSE |
| 742947-1 | Other | NY | NURSING LICENSE |
| RN702670 | Other | PA | NURSING LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, ID
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200713002738 | IN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4880017698 | Reassigns benefits to 1 organization |
| I20231011001808 | ID | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 4880017698 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain View Hospital LLC
Practice addresses (Care Compare)
2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700
Hospital & facility affiliations
- Mountain View Hospital
- Idaho Falls Community Hospital, LLC
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iceland Anesthesia Management, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Mountain View Hospital LLC | Current | Accepting new patients |
Locations
2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686
801 S Main St
Clinton, IN 47842
Phone (765) 832-1212
441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577
1421 N 7th St
Terre Haute, IN 47807
Phone (812) 231-4604
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Terre Haute, IN
- NPI 1912578667
IN, Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1114481447
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586217600000",
"number": "1992334254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2103 HERSHEY RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165094515",
"telephone_number": "208-221-8221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 N 7TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478042706",
"telephone_number": "812-238-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "BROCK",
"middle_name": "D",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-07",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28258298A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE",
"identifier": "28258298A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE",
"identifier": "N-45784",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE",
"identifier": "742947-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE",
"identifier": "RN702670",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.