JESSICA WALTHALL (NPI# 1104316454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104316454 |
| Entity Type | Individual |
| Full Name | JESSICA WALTHALL |
| Credential | PPCNP-BC |
| Practice Address |
2 W 86th St New York NY 10024-3666 |
| Mailing Address |
164 W 123rd St Apt 3 New York NY 10027-5510 |
| Practice Telephone | 6466823833 |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2018-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 137013 | CT | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 727527 | NY | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
382872 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891930475 | Jessica Ann Walthall | Specialist | 216 Main Street, Lake Village, AR 71653 | 2008-12-10 |
| Street Address |
2 W 86TH ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10024-3666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366443798 | Anna Jeong Eun Rhee | Obstetrics & Gynecology | 2 W 86th St, Ste 3a, New York, NY 10024-3666 | 2005-08-09 |
| 1013555382 | Erika Espinal | Acupuncturist | 2 W 86th St, New York, NY 10024-3666 | 2019-12-17 |
| 1942545967 | Marisol Barrion Saulog | Physical Therapist | 2 W 86th St, Suite 1, New York, NY 10024-3666 | 2012-12-02 |
| 1194987693 | Phillip Messenger | Durable Medical Equipment & Medical Supplies | 2 W 86th St, New York, NY 10024-3666 | 2008-06-26 |
| 1386810117 | Zhanna Rutstein-shulina | Obstetrics & Gynecology | 2 W 86th St, 3a, New York, NY 10024-3666 | 2008-05-01 |
| 1487795969 | Noel Ronnie Fleischer | Psychiatry & Neurology | 2 W 86th St, 4, New York, NY 10024-3666 | 2007-02-09 |
| 1407906761 | Marybeth Curran Jordan | Social Worker | 2 W 86th St, Suite 505, New York, NY 10024-3666 | 2007-01-11 |
| 1639236672 | St. Lukes- Roosevelt Hospital Center | Pediatrics | 2 W 86th St, Suite 3b, New York, NY 10024-3666 | 2007-01-02 |
| 1942361183 | Allison Emily Gati | Pediatrics | 2 W 86th St, Suite 3b, New York, NY 10024-3666 | 2006-12-12 |
| 1225114531 | Jose Licuanan Villaluz | Psychiatry & Neurology | 2 W 86th St, Suite # 507, New York, NY 10024-3666 | 2006-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023646387 | Peter Avery | Psychologist | 230 Central Park West, First Floor, #5, New York, NY 10024 | 2020-03-31 |
| 1417588526 | Amelia Rogers Lindberg | Physical Therapist | 230 West 79th Street, Apt 124s, New York, NY 10024 | 2020-01-28 |
| 1720636640 | By Your Side Services Licensed Applied Behavior Analyst Practice Pllc | Community/Behavioral Health | 105 W. 86th Street, #228, New York, NY 10024 | 2019-09-04 |
| 1407408453 | Barbara Bessin Zucker | Social Worker | 565 West End Ave. - Suite 1a, New York, NY 10024 | 2019-07-10 |
| 1609337815 | Pratistha Maharjan | Physical Therapist | 86th Street, 2w #1, Manhattan, NY 10024 | 2019-03-29 |
| 1396215968 | Sara Kahn | Nutritionist | 267 W. 89th Street Apt 5a, New York, NY 10024 | 2018-11-27 |
| 1205311586 | Matthew Ludwig Spieler | Psychologist | 255 W 88th St Apt 9e, New York, NY 10024 | 2018-10-02 |
| 1629576475 | Christopher Eldredge | Social Worker | 52 Riverside Drive, Suite 1a, New York, NY 10024 | 2018-01-26 |
| 1154850717 | Anthony William Zoghbi Md | Psychiatry & Neurology | 140 West 79th Street, Suite 1f-2, New York, NY 10024 | 2017-06-07 |
| 1821526955 | Noel Bohl-fabian | Social Worker | 140 W 79th St Apt 2b, New York, NY 10024 | 2017-06-02 |
| Find all providers in zip 10024 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992311567 | Jyneva W Pickel | Nurse Practitioner | 3959 Broadway Rm 722, New York, NY 10032-1559 | 2020-09-19 |
| 1124642061 | Corrinne L Brumit | Nurse Practitioner | 345 W 14th St Apt 6c, New York, NY 10014-5284 | 2020-06-06 |
| 1508400482 | Katherine Jane Ponsoldt | Nurse Practitioner | 529 Broome St Apt 20, New York, NY 10013-6404 | 2019-11-04 |
| 1174183487 | Sarah Winthrop Brown | Nurse Practitioner | 280 Park Ave S Apt 24e, New York, NY 10010-6134 | 2019-06-18 |
| 1043711062 | Lori Sperber | Nurse Practitioner | 10 Union Sq E Ste 5g, New York, NY 10003 | 2018-02-25 |
| 1922514116 | Jung Sin Cho | Nurse Practitioner | 46 Fort Washington Avenue, Suite 2, New York, NY 10032 | 2017-12-26 |
| 1023402401 | Lydia Louise Clark-sumpter | Nurse Practitioner | 2588 7th Ave, Apt 5c, New York, NY 10039-2605 | 2015-03-24 |
| 1487074225 | Hilary Carlson | Nurse Practitioner | 200 E 82nd St Apt 11h, New York, NY 10028-2749 | 2014-04-20 |
| 1922368943 | Nancy De Guzman | Nurse Practitioner | 160 E 32nd St Suite L3-medical, New York, NY 10016-6004 | 2012-05-23 |
| 1366700551 | Anna Aluf | Nurse Practitioner | 1468 Madison Ave Bldg 4th, New York, NY 10029-6508 | 2012-04-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.