Active NPI
Tonya A Walls
- Other Specialist/Technologist
- Hendersonville, TN
National Provider Identifier
1407308943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- 664243197
- Practice address
- 1047 Glenbrook Way Ste 100
Hendersonville, TN 37075-1315 - Phone
- (629) 239-7584
- NPI assigned
- Nov 1, 2016
- Last updated
- Jul 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21715 | TN | |
| Other Specialist/Technologist | 246Z00000X | 664243197 | TN | Primary |
Addresses
Primary practice location
1047 Glenbrook Way Ste 100
Hendersonville, TN 37075-1315
Mailing address
4 Wyndsor CT
Hendersonville, TN 37075-9601
Phone (629) 239-7584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 664243197 | TN | MD | Other Specialist/Technologist |
| 21715 | TN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1407308943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 WYNDSOR CT",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370759601",
"telephone_number": "629-239-7584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1047 GLENBROOK WAY STE 100",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370751315",
"telephone_number": "629-239-7584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "TONYA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-01",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "21715",
"primary": false
},
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "TN",
"license": "664243197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.