Christa Jo Wall, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71003894A Issued in IN

Practice address

4501 S Boundary Pike
Portland, IN 47371-8940

Phone

(765) 748-5226

NPI assigned

Oct 19, 2011

Last updated

Nov 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ameriwound Physicians in LLC

  • Specialist
  • Whiting, IN
  • NPI 1801312863
  NPD
• Union Healthcare Services Inc

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1013549468
  NPD
• Chicagoland Infectious Disease PC

  • Infectious Disease Physician
  • South Holland, IL
  • NPI 1780002352
  NPD

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1588949762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S BOUNDARY PIKE",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473718940",
            "telephone_number": "765-748-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S BOUNDARY PIKE",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473718940",
            "telephone_number": "765-748-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "CHRISTA",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003894A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Frank Vormohr, MD
• Joseph Francis Vormohr, M.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2388)
• Wal-Mart Stores East, LP (Vision Center 30-2388)
• Walgreen Co (Walgreens #12676)
• David Waters
• Whitewater Eye Centers, LLC (Eye Center of Jay County)
• Dale William Widman
• Bridgette Windau, DPT
• Witham Memorial Hospital (Persimmon Ridge Rehabilitation Centre)

• Family Nurse Practitioner in Portland, IN
• Providers in Portland, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.