Active NPI
Holly Wall
- Speech-Language Pathologist
- Smyrna, DE
National Provider Identifier
1730638735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- O4-0000489
- Practice address
- 82 Monrovia Ave
Smyrna, DE 19977-1530 - Phone
- (302) 653-8585
- NPI assigned
- Oct 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | O4-0000489 | DE | Primary |
Addresses
Primary practice location
82 Monrovia Ave
Smyrna, DE 19977-1530
Mailing address
82 Monrovia Ave
Smyrna, DE 19977-1530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O4-0000489 | DE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Delaware | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Smyrna, DE
- NPI 1730223603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1730638735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 MONROVIA AVE",
"city": "SMYRNA",
"state": "DE",
"postal_code": "199771530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 MONROVIA AVE",
"city": "SMYRNA",
"state": "DE",
"postal_code": "199771530",
"telephone_number": "302-653-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "HOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-02",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DE",
"license": "O4-0000489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.