Active NPI
Jeffrey A Wall, DO
- Family Medicine Physician
- Kennebunk, ME
National Provider Identifier
1447288808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO1877
- Practice address
- 2 Livewell Dr
Kennebunk, ME 04043-6762 - Phone
- (207) 467-8898
- Fax
- (207) 467-8969
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO1877 | ME | Primary |
Addresses
Primary practice location
2 Livewell Dr
Kennebunk, ME 04043-6762
Mailing address
2 Livewell Dr
Kennebunk, ME 04043-6762
Phone (207) 467-8898
Other practice location 1
190 Stetson Rd
Auburn, ME 04210-7813
Phone (207) 784-7388
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048350 | Other | ME | ANTHEM |
| 9386763 | Other | ME | PHCS |
| 9759878 | Other | ME | CIGNA |
| 3769958 | Other | ME | AETNA |
| 431799199 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
190 Stetson Rd
Auburn, ME 04210-7813
Phone (207) 784-7388
730 Ctr St
Suite 9
Auburn, ME 04210-6316
Phone (207) 783-3450
Hospital & facility affiliations
- Andwell Health Partners
- Andwell Health Partners
- Central Maine Medical Center
- St Mary'S Regional Medical Center
- Rumford Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.02 of 100
- Quality
- 59.99
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.25
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO1877 | ME | MD | Family Medicine Physician |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Lewiston, ME
- NPI 1689653487
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Lewiston, ME
- NPI 1780631770
-
- Home Health Agency
- Lewiston, ME
- NPI 1245232347
-
- General Acute Care Hospital
- Lewiston, ME
- NPI 1689653487
-
- Critical Access Hospital
- Rumford, ME
- NPI 1205991122
-
- General Acute Care Hospital
- Lewiston, ME
- NPI 1447226584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1447288808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 LIVEWELL DR",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040436762",
"telephone_number": "207-467-8898",
"fax_number": "207-467-8969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 LIVEWELL DR",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040436762",
"telephone_number": "207-467-8898",
"fax_number": "207-467-8969"
}
],
"practiceLocations": [
{
"address_1": "190 Stetson Rd",
"address_purpose": "LOCATION",
"city": "Auburn",
"state": "ME",
"postal_code": "042107813",
"country_code": "US",
"telephone_number": "207-784-7388",
"fax_number": "207-795-2043",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALL",
"first_name": "JEFFREY",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "DO1877",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "048350",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9386763",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9759878",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3769958",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "431799199",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennebunk, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.