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CHARLES WALKER
NPI 1104782309
Licensed Practical Nurse in Philadelphia, PA

Active since December 31, 2025
111 N 49TH ST, PHILADELPHIA, PA 19139(215) 471-2866(215) 471-2866 Get Directions Write a Review

NPPES record last updated: December 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Charles Walker NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES WALKER (NPI 1104782309) is an individual licensed practical nurse in Philadelphia, Pennsylvania, licensed in Pennsylvania (PN081780L) and active in the NPI registry since December 2025.

NPPES Registry Identity

NPI1104782309
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameCHARLES WALKER
Location Address111 N 49TH STPhiladelphia, PA 19139-2718
Mailing Address8241 Provident StPhiladelphia, PA 19150-1706 · (215) 471-2866
Phone(215) 471-2866
Fax(215) 471-2866
Sole ProprietorNo
Enumeration DateDecember 31, 2025
NPPES CertifiedDecember 31, 2025
✔ NPI 1104782309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in PA · PN081780L
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
111 N 49TH ST, Philadelphia, PA 19139
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAMANTHA MEGAN WYCKOFF MD
Psychiatry & Neurology (Addiction Medicine)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
PHILADELPHIA HEALTH MANAGEMENT CORP
Clinic/Center (Adult Mental Health)
111 N 49TH ST, 2ND FLOOR
PHILADELPHIA, PA 19139
Philadelphia County (215) 662-8881
ALLISON BOATRIGHT DNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
ERICA M BRENDEL MD PC
Psychiatry & Neurology (Psychiatry)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-1576
MS. BELLA YAMPOLSKY PA-C
Physician Assistant (Medical)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2131
MERCEDES JULIA DETTRA PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (215) 471-2600
IONA BARGE
Nurse Practitioner (Psychiatric/Mental Health)
111 N 49TH ST
PHILADELPHIA, PA 19139
Philadelphia County (214) 471-2600
CHALA SARGENT MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
111 N 49TH ST, FHC FIRST FLOOR
PHILADELPHIA, PA 19139
Philadelphia County (215) 472-7291

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Walker's NPI number?

The NPI number for Charles Walker is 1104782309. It was assigned to this individual provider in the NPPES registry on December 31, 2025.

Where is Charles Walker located?

Charles Walker practices at 111 N 49th St, Philadelphia, PA 19139. The listed phone number is (215) 471-2866.

What is Charles Walker's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Charles Walker was last updated on December 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.