Terry J Wall, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

R2G31 Issued in MO

Practice address

4323 Wornall Rd
Radiation Oncology Dept.
Kansas City, MO 64111-3229

Phone

(816) 932-2575

Fax

(816) 932-2344

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Olathe Health Physicians, Inc.

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1598784639
  Medicare reassignment NPD
• Radiology and Nuclear Medicine LLC

  • Diagnostic Radiology Physician
  • Topeka, KS
  • NPI 1699733162

  Radiation Oncology

  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1831152073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 WINCHESTER AVE",
            "address_2": "SUITE 230",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641334677",
            "telephone_number": "816-313-2667",
            "fax_number": "816-313-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 WORNALL RD",
            "address_2": "RADIATION ONCOLOGY DEPT.",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113229",
            "telephone_number": "816-932-2575",
            "fax_number": "816-932-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "TERRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "R2G31",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KS",
            "license": "04-21400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131660D",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207266107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina K Wall, RN
• Cynthia Rose Wall
• Dustin A. Wall, LPC
• James Wall
• Jeffrey W Wall, M.D
• Allie Wallace, DO
• Cynthia Calbert Wallace, M.D.
• Darryl Wallace, MD
• Dustin P Wallace, PHD
• Julie Wallace

• Radiation Oncology Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Radiation Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.