Jason T Wall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

46895 Issued in MN

Practice address

330 N 8TH Ave E
Duluth, MN 55805-2024

Phone

(218) 723-1112

NPI assigned

Jul 17, 2006

Last updated

Apr 5, 2012By 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

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

Chicago College of Medicine and Surgery, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Duluth Graduate Medical Education Council IncGroup PAC ID 4385545953, 32 clinicians

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Mary's Medical Center Hospital, Duluth, MN, CCN 240002
• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Duluth Graduate Medical Education Council Inc

  dba Duluth Family Medicine Clinic

  • Family Medicine Physician
  • Duluth, MN
  • NPI 1972585867
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic, LTD

  dba Essentia Health Hermantown Clinic

  • Multi-Specialty Clinic/Center
  • Hermantown, MN
  • NPI 1235176058
  NPD
• The Duluth Clinic, LTD

  dba Essentia Health Duluth Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• SMDC Medical Center

  dba Essentia Health Duluth

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1033153895
  NPD (past)
• St Marys Medical Center

  dba Essentia Health St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  NPD (past)

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

• St Marys Medical Center

  dba Essentia Health St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Care Compare affiliation
• St. Marys Medical Center

  dba SMMC Life Flight

  • Air Ambulance
  • Duluth, MN
  • NPI 1841359478

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1386662542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Lyn Black Walker, LADC
• Rachelle Walker, LGSW
• Sandra Walker
• Serenity Ann Walker, LAC
• Amy Lynn Walkowiak, OD
• Linda Wall, RDH
• Ashley Corrine Wallace
• Gail Ann Wallace
• Heather A Wallace, DSC., PA-C
• Janell Mae Lorton Wallace, PA-C

• Family Medicine Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.