Jonathan Earl Walls

Individual provider Active NPI Personal Care Attendant · Windham, OH

NPI 1942012174 · NPPES record last updated Jan 24, 2025

Key facts

NPI
1942012174
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
111111 (OH)
Practice address
7763 State Route 303
Windham, OH 44288-9791
Phone
(330) 442-2813
NPI assigned
Jan 24, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
111111OHMDPersonal Care Attendant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant
Group: 193400000X SINGLE SPECIALTY GROUP
3747P1801X 111111 OH Yes

Addresses

Primary practice location

7763 State Route 303
Windham, OH 44288-9791

Mailing address

7763 State Route 303
Windham, OH 44288-9791
Phone (330) 442-2813

Other providers in Windham, OH

All providers in Windham, OH · Personal Care Attendant in Ohio

Sources for this page

Verify at the official NPI Registry.