Sara Wall, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5017328 Issued in NC

Practice address

1512 E Franklin St Ste 100
Chapel Hill, NC 27514-2816

Phone

(919) 240-7269

NPI assigned

Jan 2, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Howard Brown Health CenterGroup PAC ID 1052203155, shared by 9 NPIs, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• County of Wake

  dba Wake County Health Dept

  • State or Local Public Health Clinic/Center
  • Raleigh, NC
  • NPI 1801957576
  NPD (past)
• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  NPD (past)
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1558878439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 E FRANKLIN ST STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142816",
            "telephone_number": "199-240-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 E FRANKLIN ST STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142816",
            "telephone_number": "919-240-7269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5537 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606401405",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4025 N Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606132010",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3245 N Halsted St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573419",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-296-8401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6500 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606264097",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-564-4156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "641 W 63rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606212032",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1525 E 55th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606155512",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "734 W 47th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606094411",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-1602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1512 E Franklin St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275142816",
            "country_code": "US",
            "telephone_number": "199-240-7269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 N Sheridan Rd Ste 211",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576161",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-472-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "SARA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016835",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nina Walker, ATC
• Shayla Walker, DMD
• Shirley Margaret Walker, F.N.P.
• Thanh Jennifer Walker, ANP-BC
• Hillary Blair Wall, MS, OTR/L
• Andrea S Wallace, PH.D.
• Claire Cowen Manning Wallace, CRNA
• Damon Keith Wallace, MD
• Dylan Wallace, PHARMD
• Joshua Adam Wallace, M.D. M.P.H.

• Family Nurse Practitioner in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.