KEVIN S. WALL (NPI# 1508843335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508843335 |
| Entity Type | Individual |
| Full Name | KEVIN S. WALL |
| Practice Address |
1661 Saint Anthony Ave Saint Paul MN 55104-3733 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685300 |
| Practice Fax Number | 6516460205 |
| Mailing Telephone | 6519685904 |
| Mailing Fax Number | 6519685904 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
38367 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386292357 | Kevin Alan Wall | Nurse Practitioner | 200 Front St Ste C, Vestal, NY 13850-1559 | 2019-09-03 |
| 1730709569 | Kevin M Wall | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-04-22 |
| 1376003350 | Kevin Wall | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2019-03-25 |
| 1710135199 | Kevin Wall | Physical Therapy Assistant | 307 N 5th St, Maryville, TN 37804-2921 | 2008-08-28 |
| 1760515035 | Kevin S Wall | Dentist | 340 Fairfield Ave, Bellevue, KY 41073-1175 | 2007-03-14 |
| 1285673087 | Kevin K Wall | Family Medicine | 4101 Anderson Ave, Manhattan, KS 66503-7588 | 2006-06-06 |
| 1932196367 | Kevin Ray Wall | Chiropractor | 3011 S Lindsay Rd Ste 101, Gilbert, AZ 85295 | 2005-09-30 |
| Street Address |
1661 SAINT ANTHONY AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366427601 | John L Kipp | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2005-12-09 |
| 1396303947 | Weston Obrycki | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2019-05-30 |
| 1841717188 | Michelle Ecklund | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2017-08-28 |
| 1306362140 | Bethany Rae Kadrlik | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2017-08-14 |
| 1083009674 | Lara K Sailer | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104 | 2015-04-01 |
| 1710328729 | Taylor Leigh Ellingson | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2013-07-08 |
| 1942439724 | Kyle L Hall | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-7632 | 2009-07-14 |
| 1801024922 | Theodore L Aquino | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2009-06-26 |
| 1053568634 | Heide Sue Slinde Baker | Physical Therapist | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2008-08-26 |
| 1649427444 | Wendy J Gohr | Physical Therapy Assistant | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2008-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043406127 | Francis Yogo Ngwa | Preventive Medicine | 627 Aurora Ave, Saint Paul, MN 55104-4887 | 2007-09-21 |
| 1972710739 | Betsy D Buehrer | Preventive Medicine | 3m Center Bldg 220-6w-08, Saint Paul, MN 55144-1000 | 2007-05-17 |
| 1821132598 | Carol Ley | Preventive Medicine | 3m Building # 220-6w-08, Saint Paul, MN 55144-0001 | 2007-02-16 |
| 1366427601 | John L Kipp | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2005-12-09 |
| 1487049599 | Manoj Doss | Preventive Medicine | 205 Wabasha St S, Saint Paul, MN 55107-1805 | 2015-04-06 |
| 1699092007 | Christina Lynn Cusic | Preventive Medicine | 205 Wabasha St S, Healthpartners Occupational Medicine Residency, Saint Paul, MN 55107-1805 | 2010-04-24 |
| 1063471977 | Austin N Indritz | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2006-03-20 |
| 1346209301 | Michael H Broderdorf | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2006-03-20 |
| 1497724009 | Robert Michael Wheeler | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2006-03-16 |
| 1922077999 | Vijay R Eyunni | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-7633 | 2006-03-14 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
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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.