NPIMap

Individual provider Active NPI

Julie Ann Walls, FNP-C

  • Family Nurse Practitioner
  • Logan, WV
National Provider Identifier
1780090167
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN64382-NP-C Issued in WV
Practice address
149 Jerry West Hwy Ste 2a
Logan, WV 25601-3967
Phone
(304) 752-5100
Fax
(304) 250-3685
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN64382-NP-C WV Primary

Addresses

Primary practice location

149 Jerry West Hwy Ste 2a
Logan, WV 25601-3967

Mailing address

PO Box 145
Verner, WV 25650-0145
Phone (304) 688-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150711000124 WV Practitioner - Nurse Practitioner 2062724503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

149 Jerry W Hwy
Suite 2a
Logan, WV 25601-3967

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN64382-NP-CWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County Primary Care Center, Inc. CurrentSince Apr 18, 2015 Accepting new patients
Lincoln County Primary Care Center, Inc. Current Accepting new patients
Lincoln County Primary Care Center, Inc. Current Accepting new patients
Lincoln County Primary Care Center, Inc Current Accepting new patients
Lincoln County Primary Care Center, Inc. Current Accepting new patients
Lincoln County Primary Care Center, Inc. Current Accepting new patients
Lincoln County Primary Care Center, Inc Current Accepting new patients
Lincoln County Primary Care Center, Inc. Current Accepting new patients
Lincoln County Primary Care Center, Inc Past Accepting new patients

Locations

5322 McClellan Hwy
Branchland, WV 25506
Phone (304) 824-5707

7400 Lynn Ave
Hamlin, WV 25523

1 Wildcat Way
Logan, WV 25601
Phone (304) 688-9949

122 Nick Savas Dr
Logan, WV 25601
Phone (304) 752-8081

650 E McDonald Ave
Man, WV 25635
Phone (304) 583-8585

1563 Sand Plant Rd
South Charleston, WV 25309
Phone (304) 756-1500

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1780090167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "VERNER",
            "state": "WV",
            "postal_code": "256500145",
            "telephone_number": "304-688-2373",
            "fax_number": "304-250-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 JERRY WEST HWY STE 2A",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013967",
            "telephone_number": "304-752-5100",
            "fax_number": "304-250-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN64382-NP-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

Verify at the official NPI Registry.