Demetria S Walls, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M8329 Issued in MS

Practice address

5345 Highway 18 W
Jackson, MS 39209-9421

Phone

(601) 927-0188

Fax

(601) 292-7998

NPI assigned

Jul 9, 2021

Last updated

May 8, 2023By 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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urban Rehab, Inc

  dba UR, Incorporated

  • Clinical Social Worker
  • Clinton, MS
  • NPI 1417370313
  Medicare reassignment

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1902477920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2305",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390602305",
            "telephone_number": "601-927-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 HIGHWAY 18 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392099421",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "DEMETRIA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M8329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003469743",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://urbanrehabinc.app.box.com/folder/0",
            "affiliation": "N",
            "endpointDescription": "hippa compliant data box",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "5345 Highway 18 W",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392099421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William H. Wallace
• Donald E. Waller
• Mary Marshall Waller
• Anna D Walley, FNP
• Elgin Kenneth Walley, D.D.S.
• Aaron Jamison Walpole, M.D.
• Christen Lynel Walters Haygood, M.D.
• Charles M. Walters III, CPSSP-F
• Julian Ronn Walters, DPT
• Katherine Walters, CNP

• Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.