Active NPI
Meredith Wall, DPT
- Physical Therapist
- Goodyear, AZ
National Provider Identifier
1891129052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11201
- Practice address
- 1616 N Litchfield Rd
Suite 115
Goodyear, AZ 85395-1252 - Phone
- (623) 935-0734
- Fax
- (623) 935-0934
- NPI assigned
- Aug 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501016446 | MI | |
| Physical Therapist | 225100000X | 11201 | AZ | Primary |
Addresses
Primary practice location
1616 N Litchfield Rd
Suite 115
Goodyear, AZ 85395-1252
Mailing address
PO Box 4570
Scottsdale, AZ 85261-4570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11201 | AZ | MD | Physical Therapist |
| 5501016446 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1891129052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4570",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852614570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 N LITCHFIELD RD",
"address_2": "SUITE 115",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853951252",
"telephone_number": "623-935-0734",
"fax_number": "623-935-0934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "MEREDITH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-23",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501016446",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "11201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.