Elizabeth Jean Walls, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

LB0000230 Issued in DE

Practice address

Building B-86
Omega Dr
Newark, DE 19713-6004

Phone

(302) 366-7665

Fax

(302) 366-0734

NPI assigned

Dec 15, 2009

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

Other identifiers 2

Other names 1

• Elizabeth Jean Wilson Former name

Medicare fee-for-service enrollment

Enrolled in DE, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Chester County Hospital Hospital, West Chester, PA, CCN 390179

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

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.

• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  • Hospitalist Physician
  • Newark, DE
  • NPI 1245474329
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1003850504
  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• Cardiology Consultants PA

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1841234564
  NPD (past)

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

• Chester County Hospital

  • General Acute Care Hospital
  • West Chester, PA
  • NPI 1356333579
  Care Compare affiliation
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1659600039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 CHAPMAN RD",
            "address_2": "SUITE 150",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025438",
            "telephone_number": "302-623-1929",
            "fax_number": "302-366-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING B-86",
            "address_2": "OMEGA DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197136004",
            "telephone_number": "302-366-7665",
            "fax_number": "302-366-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "ELIZABETH",
        "middle_name": "JEAN",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DE",
            "license": "LB0000230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE PROFESSIONAL LICENSE",
            "identifier": "LB0000230",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659600039",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WILSON",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Wallace
• Terence J. Wallace, MD
• Catrina Elizabeth Waller
• Joseph Waller, MD
• Syaire Waller
• Donna Marie Walsh, PHARM.D.
• Hannah Beth Walsh, PT, DPT
• James Michael Walsh, PH.D.
• Madeleine Emily Walsh, MD
• Stacey Lynne Walsh I, COTA

• Adult Health Nurse Practitioner in Newark, DE
• Providers in Newark, DE by specialty
• Adult Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.