Jody Lee Wall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.005258RX Issued in OH

Practice address

700 Childrens Dr
Columbus, OH 43205-2664

Phone

(614) 722-2000

NPI assigned

Jul 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265
  Medicare reassignment NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1245648971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Heinzerling Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432233642",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6471 Lithopolis Winchester Rd",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109583",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155679",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 W Market St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458014602",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109612",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4439 State Route 159",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018207",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "JODY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005258RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0296562",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce Wall
• Cheryl Ann Wall, CNP
• Cindy Lou Wall, RN
• Elizabeth Ann Wall
• Henrietta Wall
• Kimberly A Wall, LSW
• Patricia Wall
• Patrick M Wall, M.D.
• Sarah Allison Wall, MD
• Debora Wallace-Wood, LPC

• Physician Assistant in Columbus, OH
• Providers in Columbus, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.