Active NPI
Jo Lena Wall, PA-C
- Physician Assistant
- Plains, TX
National Provider Identifier
1154511129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02300
- Practice address
- 703 Ave G
Plains, TX 79355 - Phone
- (806) 456-6365
- Fax
- (806) 456-2057
- NPI assigned
- Jul 26, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02300 | TX | Primary |
Addresses
Primary practice location
703 Ave G
Plains, TX 79355
Mailing address
703 Ave G
Plains, TX 79355
Phone (806) 456-6365
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 |
|---|---|---|---|
| PA02300 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Yoakum | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1154511129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 AVE G",
"city": "PLAINS",
"state": "TX",
"postal_code": "79355",
"telephone_number": "806-456-6365",
"fax_number": "806-456-2057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 AVE G",
"city": "PLAINS",
"state": "TX",
"postal_code": "79355",
"telephone_number": "806-456-6365",
"fax_number": "806-456-2057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "JO",
"middle_name": "LENA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plains, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.