Itamar Wall, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11005498 Issued in FL

Practice address

13005 Southern Blvd Ste 221
Loxahatchee, FL 33470-9272

Phone

(561) 517-8678

Fax

(561) 529-5087

NPI assigned

Dec 29, 2019

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joe.wall.1@22742.direct.athenahealth.com

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

• Bind Healthcare

  • Family Nurse Practitioner
  • Loxahatchee, FL
  • NPI 1033711007

  Family

  NPD Authorized official
• Personalized and Restorative Wellness PA

  • Internal Medicine Physician
  • Loxahatchee, FL
  • NPI 1710574413

  FL

  Medicare reassignment
• Fairway Physical Therapy LLC

  • Physical Therapist
  • Palm Beach Gardens, FL
  • NPI 1376557090
  Care Compare group

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

• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairway Physical Therapy LLC 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

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

{
    "created_epoch": "1577577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1982243630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 221",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709272",
            "telephone_number": "561-517-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 221",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709272",
            "telephone_number": "561-517-8678",
            "fax_number": "561-529-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "ITAMAR",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-29",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vip Kidz Loxahatchee, LLC
• Jennifer Ann Marie Virgo
• Vitacare Inc
• Walgreen Co
• Walgreen Co
• Michal Sarah Wall, MD
• Neal Warshoff, D.O.
• Christiane Constance Hildegard Washington
• Nathan D. Watson, DO
• Jeleannea N Watts, CRNA

• All providers in Loxahatchee, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.