Patricia M Walo, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP4222 Issued in AZ

Practice address

5777 E Mayo Blvd
MCSB, 2ND Floor, Endo
Phoenix, AZ 85054-4502

Phone

(480) 301-7092

NPI assigned

Jul 28, 2006

Sex

Female

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

Nurse Practitioner

Practice roles

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.

• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Jackson, MS
  • NPI 1548219884
  NPD (past)
• Premier Medical Group of Mississippi LLC

  • Clinic/Center
  • Kosciusko, MS
  • NPI 1790827038
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1790799179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "address_2": "MCSB, 2ND FLOOR, ENDO",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "address_2": "MCSB, 2ND FLOOR, ENDO",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALO",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "674510",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Stores, Inc.
• Walmart, Inc.
• Walmart, Inc.
• Walmart, Inc.
• Johanna Walmsley
• Alexandra M Walsh, M.D.
• Douglas M Walsh, MD
• Erin Walsh, PT
• Kelly Elizabeth Walsh, CTRS
• Kelsey James Walsh, PH.D.

• Acute Care Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.