Mary Colleen Wahl, ARNP, DNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP2925992 Issued in FL

Practice address

4455 Sam Mitchell Dr
Chipley, FL 32428-3501

Phone

(850) 773-0392

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

No

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.

• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708

  FL

  Medicare reassignment Care Compare group NPD
• Northwest Florida Healthcare, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Chipley, FL
  • NPI 1659438760
  Care Compare group NPD
• Northwest Florida Healthcare, Inc.

  • Rural Health Clinic/Center
  • Chipley, FL
  • NPI 1740644202
  Care Compare group NPD (past)
• Northwest Florida Healthcare, Inc

  • Skilled Nursing Facility
  • Chipley, FL
  • NPI 1942367057
  Care Compare group
• Northwest Florida Healthcare, Inc.

  • Family Medicine Physician
  • Vernon, FL
  • NPI 1134422470
  Care Compare group
• Northwest Florida Healthcare, Inc.

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1528691102
  Care Compare group
• Northwest Florida Healthcare, Inc.

  • Rural Health Clinic/Center
  • Graceville, FL
  • NPI 1588171789
  Care Compare group
• Northwest Florida Healthcare, Inc.

  • Rural Health Clinic/Center
  • Chipley, FL
  • NPI 1598272650
  Care Compare group
• Northwest Florida Healthcare, Inc.

  • General Practice Physician
  • Vernon, FL
  • NPI 1912287939
  NPD

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

• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Florida Healthcare, Inc. 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Florida Community Hospital Hospital, Chipley, FL, CCN 101308

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleen.wahl.1@14612.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2017.

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1508370495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 GREENBAY RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "32428",
            "telephone_number": "850-658-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 SAM MITCHELL DR",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324283501",
            "telephone_number": "850-773-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "MARY",
        "middle_name": "COLLEEN",
        "credential": "ARNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2925992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• V&R Rejuvenation Drip Bar LLC
• Peter Philp Vallone Jr., PHD
• Victoria C. Vesce, LPN
• Jennifer Vinta, PTA
• Visions Adt of NWF LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Samuel Edward Ward, MD
• Washington County Ambulance
• Washington County Council on Aging, Inc.

• All providers in Chipley, FL
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.