Tonya Marie Wall

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704212472 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(313) 916-9405

NPI assigned

Nov 16, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twall61759@direct.hfhs.org

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.

• Henry Ford Health System

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1104900455
  Medicare reassignment Care Compare group
• Henry Ford Health Macomb-Oakland Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472
  Medicare reassignment NPD
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1487028379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 COLLINGHAM DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051345",
            "telephone_number": "313-526-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "TONYA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704212472",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704212472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Walker
• Yvonne Walker
• Walkers Intensive Services
• Kelli Cierra Wall, RDN
• Taygawana Wall
• Latonya Wallace-Hardiman, BA, MSA
• Bakari Wallace
• Dajuawn Wallace
• Denise Elizabeth Wallace, MA, LLP
• Inga Yvette Wallace

• Primary Care Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.