Joseph Wall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036051327 Issued in IL

Practice address

19416 E County Road 700N
Charleston, IL 61920-8550

Phone

(217) 348-1297

NPI assigned

Mar 19, 2013

Last updated

Mar 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Doctor of Medicine

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1730421629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19416 E COUNTY ROAD 700N",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619208550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19416 E COUNTY ROAD 700N",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619208550",
            "telephone_number": "217-348-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036051327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Waggoner, RPH
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• Walgreen Co. (Walgreens #11542)
• Kristen Marie Walk, APRN
• Ellie N Wallace, M.S., SLP
• Walmart Inc.
• Julie Anne Walters, MS, LSW
• Michael Warner, MS.ED, LCPC, CADC
• Mary Katherine Weber, DMD

• Family Medicine Physician in Charleston, IL
• Providers in Charleston, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.