Stephanie Ann Wall, CSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

SA0057 Issued in DC

Practice address

14909 Health Center Dr
359
Bowie, MD 20716-1007

Phone

(240) 308-0809

NPI assigned

Sep 22, 2009

Last updated

Mar 22, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1003140278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14909 HEALTH CENTER DR",
            "address_2": "359",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161007",
            "telephone_number": "240-308-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14909 HEALTH CENTER DR",
            "address_2": "359",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161007",
            "telephone_number": "240-308-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "DC",
            "license": "SA0057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1265423016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Walker
• Janet Ryan Walker, ED.D., LCPC
• Karyn Nichole Walker
• Tracey Walker, DOM
• Verna Rebecca Walker, LCPC
• Eileen L Wallace
• Erika R Wallace
• Krystle Wallace, IBCLC
• Mareesa Waltemeyer
• Mathias Wandji, PHARMD

• Surgical Assistant in Bowie, MD
• Providers in Bowie, MD by specialty
• Surgical Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.