Active NPI
Janet Myrick Wall, MED CCC SP
- Speech-Language Pathologist
- Winston-Salem, NC
National Provider Identifier
1184886848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1392
- Practice address
- 2630 Weymoth Rd
Winston-Salem, NC 27103 - Phone
- (336) 760-4138
- NPI assigned
- Jun 25, 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 | 1392 | NC | Primary |
Addresses
Primary practice location
2630 Weymoth Rd
Winston-Salem, NC 27103
Mailing address
2630 Weymoth Rd
Winston-Salem, NC 27103
Phone (336) 760-4138
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1392 | NC | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1184886848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2630 WEYMOTH RD",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-760-4138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 WEYMOTH RD",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-760-4138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "JANET",
"middle_name": "MYRICK",
"name_prefix": "Mrs.",
"credential": "MED CCC SP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "1392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.