Kevin K Wall, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0419652 Issued in KS

Practice address

4101 Anderson Ave
Manhattan, KS 66503-7588

Phone

(785) 587-4101

Fax

(785) 587-9090

NPI assigned

Jun 6, 2006

Last updated

Jul 25, 2013By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CEIABD
• Direct secure messaging: kevin.wall@khindirect.org

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.

• Stonecreek Family Physicians, LLP

  • Family Medicine Physician
  • Manhattan, KS
  • NPI 1093828097
  Medicare reassignment NPD Authorized official
• K Stat Urgent Care PA

  • Urgent Care Clinic/Center
  • Manhattan, KS
  • NPI 1356553481
  Medicare reassignment NPD
• Premier Chiropractic & Wellness, P.a.

  • Chiropractor
  • Manhattan, KS
  • NPI 1801219068
  NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1285673087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665037588",
            "telephone_number": "785-587-4101",
            "fax_number": "785-587-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665037588",
            "telephone_number": "785-587-4101",
            "fax_number": "785-587-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KEVIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0419652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100196460B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #07060)
• Walgreen Co (Walgreens #12814)
• Jeremiah Walker
• Josh G Walker, DDS
• Kaitlynn Marie Walker
• Bethany A Wallin, DPT
• Walmart Inc. (Walmart Pharmacy 10-0035)
• Reagan Mary Walsh
• Mackenzie Walters
• Megan Wanamaker

• Family Medicine Physician in Manhattan, KS
• Providers in Manhattan, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.