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JENNIFER LYNN WALLS MD NPI 1104138890


NPI Profile

NPI: 1104138890
Provider Name: JENNIFER LYNN WALLS, MD
Classification:Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
9981 S HEALTHPARK DR
FORT MYERS, FL
ZIP 33908
Get Directions

Phone: (239) 343-6260

Jennifer Lynn Walls, MD is a pediatric emergency medicine pediatrics in Fort Myers, FL. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. Jennifer Lynn Walls, MD NPI is 1104138890. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9981 S HEALTHPARK DR
FORT MYERS, FL
ZIP 33908-618
Phone: (239) 343-6260
Fax: (239) 343-6259

The NPI 1104138890 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2010 and was last updated on 3/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics29629OKLAHOMANo
2208000000XPediatricsE-11128ARKANSASNo
3208000000XPediatricsDR.0056229COLORADONo
42080P0204XPediatricsPediatric Emergency MedicineME141875FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1103693300MEDICAIDFLORIDA
2224991001MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/14/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.