Active NPI
Jan Walls
- Speech-Language Pathologist
- New Johnsonville, TN
National Provider Identifier
1083870901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1745
- Practice address
- 852 Asbury Dr
New Johnsonville, TN 37134-9673 - Phone
- (931) 380-8993
- NPI assigned
- Jul 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1745 | TN | Primary |
Addresses
Primary practice location
852 Asbury Dr
New Johnsonville, TN 37134-9673
Mailing address
852 Asbury Dr
New Johnsonville, TN 37134-9673
Phone (931) 380-8993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1745 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1083870901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "852 ASBURY DR",
"city": "NEW JOHNSONVILLE",
"state": "TN",
"postal_code": "371349673",
"telephone_number": "931-380-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "852 ASBURY DR",
"city": "NEW JOHNSONVILLE",
"state": "TN",
"postal_code": "371349673",
"telephone_number": "931-380-8993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "JAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-30",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "1745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Johnsonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.