Jaldon Wallace

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

600 W Germantown Pike Ste 400
Plymouth Meeting, PA 19462-1046

Phone

(215) 316-1776

NPI assigned

Jul 22, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Good Shepherd Health Corporation

  • Home Infusion Agency
  • Plymouth Meeting, PA
  • NPI 1144058322
  NPD

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1306674502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W GERMANTOWN PIKE STE 400",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W GERMANTOWN PIKE STE 400",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621046",
            "telephone_number": "215-316-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JALDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margarita Walker
• Sandra Walker, CNA
• Susan E Walker, PTA-IS
• Wahaba Walker, LPN
• Ayinda Wallace-Hopkins
• Karen Wallace
• Yolanda Waller
• Dawn Walls, LPN
• Ketia Enae'-Elizabeth Walls
• Debra Walsh

• Contractor in Plymouth Meeting, PA
• Providers in Plymouth Meeting, PA by specialty
• Contractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.