Brandon James Wall, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

E-3574 Issued in AR

Practice address

4400 Shuffield Ave
Little Rock, AR 72205-7100

Phone

(501) 686-9300

Fax

(501) 686-9576

NPI assigned

Dec 1, 2006

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

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Louisiana State University School of Medicine in Shreveport, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of ArkansasGroup PAC ID 6507863958, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• State of Arkansas

  • Psychiatric Hospital
  • Little Rock, AR
  • NPI 1891808630
  Medicare reassignment Care Compare group NPD
• State of Arkansas

  • Skilled Nursing Facility
  • North Little Rock, AR
  • NPI 1689117756
  NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770651408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 SHUFFIELD AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057100",
            "telephone_number": "501-686-9300",
            "fax_number": "501-686-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 SHUFFIELD AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057100",
            "telephone_number": "501-686-9300",
            "fax_number": "501-686-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "BRANDON",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "E-3574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Walker, DPT
• Sarah Elizabeth Walker
• Tracy Walker, CCC-SLP
• Tracy Walker
• Yvette Walker
• Janet O Wall, RD
• Joseph Curlin Wall, P.T.
• Ashanti Wallace, QBHP
• Brooke Wallace, LCSW
• Carmen Nicole Wallace

• Psychiatry Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.