Joshua Wall III, ATC, LAT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

AL 3641 Issued in FL

Practice address

1900 NW 13TH St
Gainesville, FL 32609-3411

Phone

(336) 908-2598

NPI assigned

Jul 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1104234145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 NW 21ST AVE APT 127",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093448",
            "telephone_number": "336-908-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093411",
            "telephone_number": "336-908-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JOSHUA",
        "name_suffix": "III",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "AL 3641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley S Walker, MASSAGE THERAPIST
• Susanna McRainey Walker, LCSW
• Sydney L Walker
• Tyler Walker
• Annette Susan Walko, LMT
• William Garfield Wall
• Beth Irene Wallace, FNP-BC
• Bethany Faith Wallace
• Ethyl Laura Wallace
• Jodi-Anne Wallace, MD

• Student in an Organized Health Care Education/Training Program in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.