Jacob Michael Walls, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS56565 Issued in FL

Practice address

1040 Malabar Rd SE
Palm Bay, FL 32907-3251

Phone

(321) 723-2101

NPI assigned

Aug 20, 2018

Last updated

Aug 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1902386865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 FLAMINGO AVE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329278125",
            "telephone_number": "321-591-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MALABAR RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329073251",
            "telephone_number": "321-723-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Anthony Walker, M.D.
• William Walker, L.M.H.C.
• Shenikwa Wallace-Jackson
• Kasia Layne Wallace-Shaw, MD
• Sarilyne Grace Walley
• Kendra T Walsh
• Simone Walton, LMSW, DSW
• Onesimus Devon Warner Sr., LDO
• Timika Marie Washington
• Vanessa Denise Waszkiewicz, LMHC

• Pharmacist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.