Jordan Wall, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-159731 Issued in AL

Practice address

810 Saint Vincents Dr
Birmingham, AL 35205-1601

Phone

(205) 939-7000

NPI assigned

Apr 1, 2024

Last updated

Apr 25, 2024By 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

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diabetes Management Partners LLCGroup PAC ID 9436435385, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Vincent's East Hospital, Birmingham, AL, CCN 010011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jordan.wall.p1@direct.birminghampulm.nextgenshare.com

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.

• Diabetes Management Partners LLC

  dba GlyCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Bethpage, NY
  • NPI 1013461193

  AL

  Medicare reassignment Care Compare group NPD
• STV Pulmonary Group LLC

  • Pulmonary Disease Physician
  • Birmingham, AL
  • NPI 1548797566
  Medicare reassignment NPD
• Diabetes Management Partners LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Bel Air, MD
  • NPI 1245101617
  NPD
• Birmingham Pulmonary Group,P.C.

  • Specialist
  • Birmingham, AL
  • NPI 1578504338
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Vincent's East

  dba Ascension St. Vincent's East

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1841308020
  Care Compare affiliation

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1972354538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566921",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SAINT VINCENTS DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051601",
            "telephone_number": "205-939-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JORDAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-159731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anji Elizabeth Wall, MD
• Anna Glyn Wall
• Austin David Wall III, MD
• Clarice Wall, MD
• Jaclyn A Wall, M.D.
• Kevin M Wall, MD
• Peyton William Wall, MD
• Terry Wall, M.D.
• Leigh E. Wallace Ivy, CRNA
• Andrew Wallace, PHARMD, RPH

• Acute Care Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.