DR. MICHAEL JASON WALLS (NPI# 1083888325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083888325 |
Entity Type | Individual |
Full Name | DR. MICHAEL JASON WALLS |
Credential | M.D. |
Practice Address |
320 Thomas More Pkwy Suite 202 Crestview Hills KY 41017-3410 |
Mailing Address |
120 Executive Park Louisville KY 40207-4201 |
Practice Telephone | 8593310432 |
Practice Fax Number | 8593310956 |
Mailing Telephone | 5024099925 |
Mailing Fax Number | 5029199780 |
Enumeration Date | 2008-04-17 |
Last Update Date | 2019-01-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
42678 | KY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ANTHEM ID | 000001148521 | 01 | |
CARESOURCE ID | CS1811400200 | 01 | |
AETNA PIN | 9318357 | 01 | |
OH | 0295938 | 05 | |
IN | 300012365 | 05 | |
KY | 7100086870 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932383593 | Michael A Walls | Military Health Care Provider | 3399 Strauss Ave, Suite 219, Indian Head, MD 20640-5164 | 2007-12-19 |
1124141411 | Michael Robert Walls | Occupational Therapist | 435 Main St Ste A, Franklin, TN 37064-2757 | 2007-04-09 |
1679579791 | Michael James Walls | Specialist | 4015 I 45 N Ste 310, Conroe, TX 77304-5077 | 2005-06-23 |
1497877526 | Michael C Walls | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290-1028 | 2007-04-06 |
1841273992 | Michael Edward Walls | Physical Therapist | 7 Carnegie Plz, Cherry Hill, NJ 08003-1000 | 2005-11-22 |
1063415875 | Michael W Walls | Nurse Anesthetist, Certified Registered | 1 E New York Ave, Somers Point, NJ 08244-2340 | 2005-05-24 |
Street Address |
320 THOMAS MORE PKWY SUITE 202 |
City | CRESTVIEW HILLS |
State | KY |
Zip Code | 41017-3410 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679556765 | Philip S. Becker | Psychiatry & Neurology | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2005-11-22 |
1982839940 | Elizabeth M. R. Dragan | Psychiatry & Neurology | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2009-05-20 |
1215070057 | David C Quast | Dentist | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2007-02-14 |
1760585954 | John Todd Perkins | Psychiatry & Neurology | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2006-09-06 |
1932201845 | Katherine Lee Bushong | Nurse Practitioner | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2006-09-01 |
1346359387 | Maureen Li | Psychiatry & Neurology | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2006-08-30 |
1447367156 | James Farrell | Psychiatry & Neurology | 320 Thomas More Pkwy, Crestview Hills, KY 41017-3410 | 2006-08-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
Find all providers in zip 41017 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346766441 | Integrated Pain Management of Kentucky LLC | Pain Medicine | 210 Thomas More Pkwy Ste B, Crestview Hills, KY 41017-3429 | 2017-08-21 |
1588093694 | Neuroscience Associates of Northern Kentucky,psc | Pain Medicine | 2845 Chancellor Dr, Crestview Hills, KY 41017-3418 | 2013-11-08 |
1801113071 | Lester S Duplechan Md Pllc | Pain Medicine | 350 Thomas More Pkwy, Ste 190, Crestview Hills, KY 41017-5465 | 2010-04-28 |
1144293275 | Philip L Zaacks | Pain Medicine | 350 Thomas More Pkwy, Suite 160, Crestview Hills, KY 41017-5465 | 2006-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528554474 | Hillcrest Pain & Spine Pllc | Pain Medicine | 853 Lane Allen Rd Ste 217, Lexington, KY 40504 | 2018-07-03 |
1578981718 | Restore Rehabilitation | Pain Medicine | 6400 Dutchmans Pkwy Ste 80, Louisville, KY 40205-3340 | 2014-04-04 |
1508201898 | Center for Pain Management | Pain Medicine | 440 B High St, Bowling Green, KY 42101 | 2013-05-01 |
1689994154 | Cumberland Brain and Spine, Pllc | Pain Medicine | 1641 Scottsville Rd, Bowling Green, KY 42104-3244 | 2010-06-08 |
1235358243 | Gary L Reasor, Md P.s.c | Pain Medicine | 4121 Dutchmans Ln Ste 606, Louisville, KY 40207-4725 | 2007-04-25 |
1407995517 | Cassari Pain Treatment Center Inc | Pain Medicine | 4010 Dupont Circle #430, Louisville, KY 40207 | 2007-02-05 |
1922186378 | Tri-state Advanced Pain Management Pllc | Pain Medicine | 3332 Villa Pt Ste 104, Owensboro, KY 42303-7818 | 2006-11-02 |
1164518080 | David P Bosomworth II | Pain Medicine | 279 Kings Daughters Dr Ste 100, Frankfort, KY 40601 | 2006-10-05 |
1639263338 | Bluegrass Pain Management, Psc | Pain Medicine | 1760 Nicholasville Road, Suite 503, Lexington, KY 40503 | 2006-10-03 |
1265525653 | Bill Walker Haney | Pain Medicine | 6400 Dutchmans Pkwy Ste 60, Louisville, KY 40205-3341 | 2006-09-30 |
Find all providers with the same taxonomy |
City | CRESTVIEW HILLS |
Zip Code | 41017 |
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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.