Anthony Wall, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R045285 Issued in GA

Practice address

740 Prince Ave
Athens, GA 30606-5908

Phone

(706) 548-0008

Fax

(706) 369-9673

NPI assigned

Feb 1, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1740327139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N MILLEDGE AVE STE B",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013806",
            "telephone_number": "706-548-0008",
            "fax_number": "706-369-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065908",
            "telephone_number": "706-548-0008",
            "fax_number": "706-369-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "R045285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "988504591A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Walker, LAT, ATC
• Jennifer Maxey Walker, RD, LD
• Jerri L Walker, CNM
• Rebecca Walkup, LPN
• Alexandra Wall
• Kelly E. Wall, ANP-BC
• Ansley Wallace
• Rex Michael Wallace, NP
• Stephanie R Wallace, NP
• Esther Wimlen Wallach, M.D., M.SC.

• Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.