James Allen Walla, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704267270 Issued in MI

Practice address

4250 Plymouth Rd
Ann Arbor, MI 48109-2700

Phone

(734) 764-6443

NPI assigned

Sep 8, 2020

Last updated

Mar 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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.

• Regents of the University of Michigan

  • Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1447275102
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Pontiac, MI
  • NPI 1275718686
  NPD (past)
• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Brockton, MA
  • NPI 1992521512
  NPD (past)

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1689288615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-764-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLA",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704267270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Waterford",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "279 Summit Dr Ste 200",
            "city": "Waterford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483283364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Susan Walkowiak, NP
• Angela Marie Wall, LMSW
• Erin Wall
• Krysten Wall, LMSW
• Sarah Catherine Wall, MD
• Beth Ilene Wallace, MD
• Julia Wallace, MSW
• Leanne Michelle Wallace, RDH
• Michael Eugene Wallace, MA
• Nicholas Wallace, M.D.

• Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.