Jill Suzanne Wall, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1193 Issued in TN

Practice address

742 Middlecreek Rd
Sevierville, TN 37862-5047

Phone

(865) 446-8835

NPI assigned

Jun 12, 2006

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 3

Other names 1

• Ms. Jill Suzanne Day Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Merit-based Incentive Payment System (MIPS)

Final score

77.77 of 100Reported as group

Quality

58.61

Promoting interoperability

92

Improvement activities

40

Cost

73.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jill.wall.p1@direct.bmpg.nextgenshare.com
• Direct secure messaging: jwall864462@direct.ghs.myhfn.org

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.

• Blount Memorial Physician Group, Inc

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1699710194
  Medicare reassignment Care Compare group
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment

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

• Prisma Health - Blount Memorial Hospital Inc.

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1043252190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 SPRINGTIME TRL",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "378653256",
            "telephone_number": "865-789-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 MIDDLECREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625047",
            "telephone_number": "865-446-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRGA",
            "identifier": "P00285556",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4095095",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3663358",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "DAY",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East, LP
• Walgreen Co
• Walgreen Co
• Walgreen Co.
• Walgreens
• Linda S Ward
• Watco Communities, LLC
• Brianna Watson
• Raki Watson
• Webb Foot and Ankle Clinic PC

• Physician Assistant in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.