Individual provider Active NPI

Jayde S. Wall, NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1013566884
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71009529A Issued in IN
Practice address
1030 W Michigan St FL 2
Indianapolis, IN 46202-5201
Phone
(317) 944-7241
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 28216495A IN
Gerontology Nurse Practitioner 363LG0600X 71009529A IN Primary

Addresses

Primary practice location

1030 W Michigan St FL 2
Indianapolis, IN 46202-5201

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwall5@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029003376 IN Practitioner - Nurse Practitioner 7113259870 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161
  • Iu Health West Hospital Hospital, Avon, IN, CCN 150158
  • Indiana University Health White Memorial Hospital Hospital, Monticello, IN, CCN 151312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28216495AINMDAdult Health Nurse Practitioner
71009529AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc CurrentSince Feb 5, 2021 Accepting new patients
University Obstetricians-Gynecologists,Inc CurrentSince Dec 1, 2019 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

7845 Solution Ctr
Chicago, IL 60677

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

550 University Blvd
#2440
Indianapolis, IN 46202
Phone (317) 274-1661

1030 W Michigan St
Fl 2
Indianapolis, IN 46202
Phone (317) 944-0920

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1030 W Michigan St
Indianapolis, IN 46202
Phone (317) 944-0920

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

Interoperability endpoints

  • Direct secure messaging: jwall5@direct.iuhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1013566884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W MICHIGAN ST FL 2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025201",
            "telephone_number": "317-944-7241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "JAYDE",
        "middle_name": "S.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "28216495A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009529A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwall5@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1030 W Michigan St Fl 2",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.