JOHN WALL (NPI# 1538661665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538661665 |
| Entity Type | Individual |
| Full Name | JOHN WALL |
| Practice Address |
111 Sequoyah Ln Altus OK 73521-1756 |
| Mailing Address |
Po Box 175 Altus OK 73522-0175 |
| Practice Telephone | 5804822809 |
| Practice Fax Number | 5804822820 |
| Mailing Telephone | 5804822809 |
| Mailing Fax Number | 5804822820 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982725628 | John Thomas Wall | Chiropractor | 218 E. Woodin Avenue, Chelan, WA 98816-1180 | 2007-04-02 |
| 1154441137 | John P Wall | Occupational Therapist | 2 Bon Aire Ter, Pittston, PA 18640-3202 | 2007-03-31 |
| 1396880738 | John Edward Wall | Pharmacist | 26317 W. Washington Street Extended, Petersburg, VA 23803-0030 | 2007-02-21 |
| 1972694396 | John Charles Blakely Wall | Chiropractor | 1334 Mackey Branch Dr, Suite 104, Chattanooga, TN 37421-3471 | 2006-09-28 |
| 1114347689 | John Robert Wall IIi | Anesthesiology | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2014-04-23 |
| 1528116464 | John K. Wall | Emergency Medicine | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-01-08 |
| 1417058827 | John Gregory Wall | Dentist | 404 People Pl, Suite 301, Charlottesville, VA 22911-3565 | 2006-09-26 |
| 1316044324 | John Wall | Nurse Anesthetist, Certified Registered | 800 E Locust St, Olney, IL 62450-2553 | 2006-09-20 |
| 1942317292 | John P. Wall | Family Medicine | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2006-08-24 |
| 1043229727 | John W Wall | Podiatrist | 1411 W Olive Ave, Suite C, Burbank, CA 91506-2427 | 2006-08-05 |
| Street Address |
111 SEQUOYAH LN |
| City | ALTUS |
| State | OK |
| Zip Code | 73521-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255834156 | Amanda Jane Bernasconi | Case Manager/Care Coordinator | 111 Sequoyah Ln, Altus, OK 73521-1756 | 2018-03-16 |
| 1285137216 | Jeanne Lee Brandon | Social Worker | 111 Sequoyah Ln, Altus, OK 73521-1756 | 2018-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 1598025827 | Dustin James Robins | Counselor | 1052 E Cherry St, Altus, OK 73521 | 2012-05-21 |
| 1831471101 | Manda Lea Stephens | Nurse Practitioner | 205 S. Park Lane, Altus, OK 73521 | 2011-09-13 |
| 1649439167 | Lisa Michelle Shelton | Pharmacist | 2500 N Main, Altus, OK 73521 | 2008-06-09 |
| 1114192911 | Richard G. Henry | Health Maintenance Organization | 112 Val Verde, Altus, OK 73521 | 2008-04-23 |
| 1194881060 | Resters Diabetic Shoes and Home Medical | Durable Medical Equipment & Medical Supplies | 103 West Commerce Street, Altus, OK 73521 | 2006-12-28 |
| 1265592141 | Noble L Ballard.medical Clinic, Pllc | Family Medicine | 1015 East Broadway Street, Stuite 101, Altus, OK 73521 | 2006-12-11 |
| 1457377822 | Comanche County Healthcare | Family Medicine | 3000 N Main St, Suite A, Altus, OK 73521 | 2006-07-15 |
| 1326095381 | Charles C Carter Md Dph Pllc | Family Medicine | 1015 E Broadway St, Suite 102, Altus, OK 73521 | 2006-05-27 |
| 1013988179 | Carol Marie Sherman | Family Medicine | 205 S Park Ln, Altus, OK 73521 | 2006-01-27 |
| Find all providers in zip 73521 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538506480 | Kimberly Kay Carpenter | Counselor | 1506 Adams St, Altus, OK 73521-6913 | 2013-06-02 |
| 1467714766 | Tracy J Lorah | Counselor | 305 N Hudson St, Altus, OK 73521-3709 | 2012-06-12 |
| 1598025827 | Dustin James Robins | Counselor | 1052 E Cherry St, Altus, OK 73521 | 2012-05-21 |
| 1740587831 | Deann Dolores Minst | Counselor | 307 Cameron Dr, Altus, OK 73521-2110 | 2011-02-25 |
| 1477850733 | Isabella Suzanne Norton | Counselor | 21059 E County Road 155, Altus, OK 73521-8402 | 2011-02-23 |
| 1710406749 | Rebecca Merre Waechter | Counselor | 1200 E Tamarack Rd, Altus, OK 73521-1234 | 2017-09-11 |
| 1023463841 | April M Dill | Counselor | 123 W Commerce St, 5th Floor, Altus, OK 73521-3850 | 2016-04-29 |
| 1922406081 | Kiona Marie Fowler | Counselor | 118 N Main St, Altus, OK 73521-3102 | 2014-12-05 |
| 1821407727 | Erika Davis | Counselor | 118 N Main St, Altus, OK 73521-3102 | 2014-08-05 |
| 1285977561 | Lori Jean Baker | Counselor | 118 N Main St, Altus, OK 73521-3102 | 2013-04-04 |
| Find all providers in ALTUS | ||||
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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.