Mikayla Wall

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008117 Issued in VA

Practice address

1802 Braeburn Dr
Salem, VA 24153-7357

Phone

(540) 772-3702

NPI assigned

Jun 28, 2021

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

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johnson Health CenterGroup PAC ID 9537060413, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.16 of 100Reported as apm

Quality

83.58

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mikayla.wall@hca6.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1316926538
  Medicare reassignment Care Compare group NPD
• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  Physician Assistant, VA

  Medicare reassignment NPD
• Bedford Family Urgent Care, Inc

  • Family Medicine Physician
  • Bedford, VA
  • NPI 1033150115
  Medicare reassignment
• Centra Health Professional Services, LLC

  dba Piedmont Psychiatric Center

  • Psychiatry Physician
  • Lynchburg, VA
  • NPI 1063452480
  NPD
• Johnson Health Center

  dba Amherst County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Madison Heights, VA
  • NPI 1972858660
  NPD
• Johnson Health Center

  dba Lynchburg Women's and Pediatric Health Services

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1821212481
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1265002836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 SUNBURST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245017249",
            "telephone_number": "434-944-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "434 Sunburst Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245017249",
            "country_code": "US",
            "telephone_number": "434-944-2860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "MIKAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preston Adam Waldrop, M.D.
• Walgreen Co (Walgreens #07604)
• Lorie Walker
• Shanique L Walker, BEHAVIOR TECHNICIAN
• Wall Therapeutic Solutions, LLC (Wall Therapeutic Solutions)
• Caroline Wallace, DDS
• Robert Edward Wallace, DDS
• Sadie Wallace
• Ward Transitional Services Inc
• Melissa Ward

• Physician Assistant in Salem, VA
• Providers in Salem, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.