Gary Wall, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

CPO04318

Practice address

1031 W Williams St Ste 104
Apex, NC 27502-3955

Phone

(919) 267-5284

Fax

(888) 635-6138

NPI assigned

Jul 1, 2019

Last updated

Jul 1, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1427610435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 FORESTVIEW RD STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122391",
            "telephone_number": "919-977-9727",
            "fax_number": "888-635-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 W WILLIAMS ST STE 104",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023955",
            "telephone_number": "919-267-5284",
            "fax_number": "888-635-6138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3708 Forestview Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276122391",
            "country_code": "US",
            "telephone_number": "919-977-9727",
            "fax_number": "888-635-6138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "GARY",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": "CPO04318",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": "CPO04318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP (Vision Center 30-3889)
• Karen Byrns Waldman, OTR
• Walgreen Co (Walgreens #07365)
• Walgreen Co (Walgreens #11504)
• Walgreen Co (Rite Aid)
• Lindsey Walsh
• Christopher Jordan Walston, PHARMD, BCACP
• Terese Marie Walters, DMD
• Kailaha Walton
• Li Wang, ARNP

• Prosthetist in Apex, NC
• Providers in Apex, NC by specialty
• Prosthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.