MRS. MICHELLE DEANNA WALL (NPI# 1619195302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619195302 |
| Entity Type | Individual |
| Full Name | MRS. MICHELLE DEANNA WALL |
| Credential | PA-C |
| Practice Address |
348 N South St Mount Airy NC 27030-3532 |
| Practice Telephone | 3367866945 |
| Practice Fax Number | 3367895782 |
| Mailing Telephone | 3367866945 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2009-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
103078 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE PTAN | 2759201 | 01 |
| NC | MEDICARE GROUP/ORGANIZATION PTAN | 2291842C | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629626171 | Michelle Kristine Wall | Licensed Vocational Nurse | 8001 S Us Highway 75, Sherman, TX 75090-5707 | 2019-08-28 |
| 1366858748 | Michelle M Wall | Physical Therapist | 651 Nicollet Mall Ste 275, Minneapolis, MN 55402 | 2014-07-07 |
| 1730424623 | Michelle Wall | Occupational Therapist | 296 Hamburg Tpke, Wayne, NJ 07470-2150 | 2012-12-03 |
| 1104081447 | Michelle Anne Wall | Dentist | 255 N Gilbert St, Suite C2, Hemet, CA 92543-4066 | 2008-07-25 |
| 1104002716 | Michelle Dana Wall | Massage Therapist | 4601 Excelsior Blvd, 407, Saint Louis Park, MN 55416-4960 | 2008-01-14 |
| 1639186349 | Michelle Girouard Wall | Internal Medicine | 300 20th Ave N, 7th Floor, Nashville, TN 37203-2131 | 2006-08-02 |
| 1942258330 | Michelle Wall | Physical Therapist | 200 Newport Center Dr, #213, Newport Beach, CA 92660-7501 | 2006-05-05 |
| Street Address |
348 N SOUTH ST |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030-3532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922518745 | Med First Immediate Care & Family Practice, Pa | Clinic/Center | 348 N South St, Mount Airy, NC 27030-3532 | 2017-10-06 |
| 1053841619 | Med First Immediate Care & Family Practice Pa | Family Medicine | 348 N South St, Mount Airy, NC 27030-3532 | 2017-06-15 |
| 1639585102 | Kristi Massey | Nurse Practitioner | 348 N South St, Mount Airy, NC 27030-3532 | 2014-07-06 |
| 1871768507 | Majure Skin Care & Wellness Center, Pa | Family Medicine | 348 N South St, Mount Airy, NC 27030-3532 | 2008-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285763185 | Michelle Williams Combs | Physician Assistant | 865 W Lake Dr Ste 200, Mount Airy, NC 27030-2135 | 2007-03-05 |
| 1629410113 | Asima Q Athar | Physician Assistant | 826 Marshall St, Mount Airy, NC 27030-4460 | 2013-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
Please comment or provide details below to improve the information on MRS. MICHELLE DEANNA WALL.
| 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.