Mary Elizabeth Wall

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1057 Issued in NM

Practice address

7 Coyote Court
Box 2290 RDT, NM 87557
Taos, NM 87571

Phone

(575) 758-5763

NPI assigned

Mar 24, 2009

Last updated

Mar 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Betsy Wall Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1780826636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2290",
            "city": "RANCHOS DE TAOS",
            "state": "NM",
            "postal_code": "875572290",
            "telephone_number": "575-758-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 COYOTE COURT",
            "address_2": "BOX 2290 RDT, NM 87557",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "WALL",
            "credential": "MA-CCC/SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nikki Vue
• Carl Wagner, D.O.M.
• Howard Waitzkin, MD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0873)
• Walgreen Co (Walgreens #12751)
• Sherry Renea Wall, RN
• Sarah Waller
• John Michael Walsh, SCHOOL PSYCHOLOGIST
• Susan Warner
• Ellen Rhea Warren, MD

• Speech-Language Pathologist in Taos, NM
• Providers in Taos, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.