Active NPI
Mary Jo Wall, NP
- Family Nurse Practitioner
- Washington Court House, OH
National Provider Identifier
1467592667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP05601
- Practice address
- 1227 U S Route 22 S W
Washington Court House, OH 43160-1882 - Phone
- (740) 333-3310
- Fax
- (740) 333-4303
- NPI assigned
- Feb 7, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP05601 | OH | Primary |
Addresses
Primary practice location
1227 U S Route 22 S W
Washington Court House, OH 43160-1882
Mailing address
1301 Greensview LN
Washington Court House, OH 43160-1882
Phone (740) 335-3433
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP05601 | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467592667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 GREENSVIEW LN",
"city": "WASHINGTON COURT HOUSE",
"state": "OH",
"postal_code": "431601882",
"telephone_number": "740-335-3433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 U S ROUTE 22 S W",
"city": "WASHINGTON COURT HOUSE",
"state": "OH",
"postal_code": "431601882",
"telephone_number": "740-333-3310",
"fax_number": "740-333-4303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "MARY JO",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "NP05601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington Court House, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.