STEPHEN JAY WALL (NPI# 1467454462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467454462 |
| Entity Type | Individual |
| Full Name | STEPHEN JAY WALL |
| Credential | M.D. |
| Practice Address |
15 Facility Dr Clyde NC 28721-9438 |
| Practice Telephone | 8284522211 |
| Practice Fax Number | 8284524421 |
| Mailing Telephone | 8284522211 |
| Mailing Fax Number | 8284524421 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
38234 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED HEALTHCARE | 1270239 | 01 | |
| NC | 8985406 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801250105 | Stephen Wall | Student in an Organized Health Care Education/Training Program | 525 E Market St, Summa Health System/pathology Residency, Akron, OH 44304-1619 | 2016-04-12 |
| 1033503388 | Stephen Lee Wall | Internal Medicine | 4860 Y St Ste 200, Sacramento, CA 95817-2307 | 2015-03-25 |
| 1740345719 | Stephen Wall | Emergency Medicine | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2006-12-27 |
| 1801950613 | Stephen N Wall | Pediatrics | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2006-12-19 |
| 1861405706 | Stephen Joseph Wall | Otolaryngology | 3 Washington Cir Nw, Suite 401, Washington, DC 20037-2356 | 2006-08-14 |
| Street Address |
15 FACILITY DR |
| City | CLYDE |
| State | NC |
| Zip Code | 28721-9438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932100138 | Karin R. Mclelland | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-10 |
| 1992972947 | Melissa F Sommerich | Physician Assistant | 15 Facility Dr, Clyde, NC 28721-9438 | 2008-05-09 |
| 1922275064 | Anne M Sarzynski | Nurse Practitioner | 15 Facility Dr, Clyde, NC 28721-9438 | 2008-05-08 |
| 1679773360 | Sarah Webb-wood | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2007-07-20 |
| 1043419666 | Tyler Bagley Vereen | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2007-07-13 |
| 1851393763 | Steven D. Hammel | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-11 |
| 1245231364 | Haywood Pediatric and Adolescent Medicine Group, P.a. | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659828366 | Arcadia Pathology Network, Pllc | Pathology | 262 Leroy George Dr Pathology, Clyde, NC 28721 | 2016-09-10 |
| 1063760999 | Jenny Helms Caldwell | Pharmacist | 231 Ironwood Dr., Clyde, NC 28721 | 2012-08-27 |
| 1306112958 | Lynette Mount | Specialist/Technologist | 76 Leroy George Drive, Clyde, NC 28721 | 2012-03-28 |
| 1821242926 | Haywood Regional Medical Center | Clinic/Center | 75 Leroy George Drive, Clyde, NC 28721 | 2008-11-17 |
| 1770757338 | Colin James Bridger | Physical Therapist | 262 Leroy George Dve, Clyde, NC 28721 | 2008-04-15 |
| 1851585236 | Lori Anne Gerber | Counselor | 33 Sharon Lynne Way, Clyde, NC 28721 | 2007-08-29 |
| 1487779328 | Sandra Y Fowler | Social Worker | 73 Main St., Clyde, NC 28721 | 2007-03-20 |
| 1164593810 | County of Haywood | Case Management | 157 Paragon Pkwy Ste 300, Clyde, NC 28721 | 2006-11-13 |
| 1992779730 | Leroy S Crapanzano Jr. | Dentist | 157 Paragon Parkway, Haywood County Health Department, Clyde, NC 28721 | 2006-02-16 |
| 1063492007 | Ann Marie Mcdonald | Nurse Practitioner | 360 Hospital Dr Ste 120, Clyde, NC 28721 | 2006-01-17 |
| Find all providers in zip 28721 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932100138 | Karin R. Mclelland | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-10 |
| 1851393763 | Steven D. Hammel | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-11 |
| 1245231364 | Haywood Pediatric and Adolescent Medicine Group, P.a. | Pediatrics | 15 Facility Dr, Clyde, NC 28721-9438 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306268594 | Sollus Health, Pllc | Pediatrics | 547 Keisler Dr Ste 103, Cary, NC 27518-9309 | 2014-01-08 |
| 1740622166 | Sunshine Pediatric and Adolescent Care | Pediatrics | 1631 Midtown Pl Ste 107, Raleigh, NC 27609-1300 | 2013-07-26 |
| 1134265721 | Daniel Elmer Brown | Pediatrics | 2412 Ridge Rd, Raleigh, NC 27612-4759 | 2007-01-30 |
| 1417003385 | Renuka Shiv Harsh | Pediatrics | 218 Foust St Ste B, Asheboro, NC 27203-5476 | 2007-01-25 |
| 1932254687 | Rollyn Michelle Ornstein | Pediatrics | 4024 Stirrup Creek Drive, Durham, NC 27703 | 2007-01-24 |
| 1881743763 | Masoud Ahdieh | Pediatrics | 711 S Long Dr, Rockingham, NC 28379-4315 | 2007-01-09 |
| 1609966647 | Robert W Little | Pediatrics | 2505 S Mebane St, Suite A, Burlington, NC 27215-6385 | 2006-10-13 |
| 1487755567 | Charles Richardson Martin | Pediatrics | 2 Dewitt St, Jacksonville, NC 28540-5649 | 2006-09-25 |
| 1710094487 | William Clayton Hayes Jr. | Pediatrics | 825 Majestic Ct Ste B, Gastonia, NC 28054-5186 | 2006-08-25 |
| 1285650945 | Andrew Kenneth Kiluk | Pediatrics | 3701 John Platt Drive, Morehead City, NC 28557-3280 | 2006-07-14 |
| Find all providers with the same taxonomy | ||||
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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.