DR. SHANNON NICOLE WALKER (PH.D.) – Clinical Psychologist, NPI 1801020573

DR. SHANNON NICOLE WALKER (PH.D.) is a healthcare provider. based in Glen carbon, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 071.007664 (IL). The NPI Number for DR. SHANNON NICOLE WALKER (PH.D.) is 1801020573

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANNON NICOLE WALKER (PH.D.)
NPI
1801020573
Phone
(618) 710-4123
Address
9 JUNCTION DR W
Enumeration Date
11 May 2009
Last Update Date
4 June 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2007 (19 years ago)
PAC ID
8224160908
Group Practice PAC ID
8527190206
Professional Enrollment ID
I20100715000415
Address ID
IL620342931Gl9XXXXWXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

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Provider Addresses for DR. SHANNON NICOLE WALKER (PH.D.)

  • Junction Drive, Glen Carbon, Madison County, Illinois, 62034, United States

    SUITE 6

    GLEN CARBON, IL 620342931

    Phone: (618) 710-4123

    Fax: (618) 731-4082

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100715000415IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes24819$0
90791Psychiatric diagnostic evaluation7575$0
96131Evaluation of psychological test, each additional hour7265$0
96130Evaluation of psychological test, first hour6565$0
96136Administration of psychological or neuropsychological test, first 30 minutes6565$0
View full utilization report →

Insurance plans in this area (ZIP 62034)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527190206View full group profile
NameSpecialtyState
Mental Health CounselorIL
-IL
Clinical Social WorkerIL
Clinical Social WorkerIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

Where can patients find DR. SHANNON NICOLE WALKER (PH.D.)'s NPI?
You can confirm DR. SHANNON NICOLE WALKER (PH.D.) with NPI 1801020573; it appears in the national provider directory.
Does this profile mean DR. SHANNON NICOLE WALKER (PH.D.) is currently active?
Yes — DR. SHANNON NICOLE WALKER (PH.D.) appears active in the national provider directory.
Does DR. SHANNON NICOLE WALKER (PH.D.) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for DR. SHANNON NICOLE WALKER (PH.D.). Clinical services aligned with this taxonomy classification.
Does DR. SHANNON NICOLE WALKER (PH.D.) practice in Illinois?
You will see Glen Carbon, Illinois on file for DR. SHANNON NICOLE WALKER (PH.D.) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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