Individual provider Active NPI

Linda A Walls, PA C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1356303200
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113175 Issued in FL
Practice address
1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone
(239) 938-2000
Fax
(239) 278-0404
NPI assigned
Apr 5, 2006
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113175 FL Primary
Physician Assistant 363A00000X 0010-01649 NC
Medical Physician Assistant 363AM0700X 0010-01649 NC

Addresses

Primary practice location

1550 Barkley Cir
Fort Myers, FL 33907-4539

Mailing address

1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone (239) 938-2000

Other identifiers 2

IdentifierTypeStateIssuer
109075000MedicaidFL
XFGIHOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121129000153 NC Practitioner - Physician Assistant 7416932173 Reassigns benefits to 1 organization
I20210107001735 FL Practitioner - Physician Assistant 7416932173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Consultants of Southwest Florida IncGroup PAC ID 9335114552, 9 clinicians

Practice addresses (Care Compare)

13411 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1873
Phone (239) 415-4900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113175FLMDPhysician Assistant
0010-01649NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Consultants of Southwest Florida, Inc. CurrentSince Jan 5, 2026 Accepting new patients
Tyler Cardiovascular Consultants P.a. Medical Past Accepting new patients

Locations

13411 Parker Commons Blvd
Ste 101
Fort Myers, FL 33912
Phone (239) 415-4900

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1356303200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "LINDA",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-06-01",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113175",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01649",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01649",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109075000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "XFGIH",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.