MICHAEL WALL, PC
NPI 1023727633
Clinic/Center - Primary Care in Maryville, TN

Active since November 22, 2022CLIA 44D2271402 · Waiver
362 HIGH ST, MARYVILLE, TN 37804(865) 413-1589(865) 205-9475 Get Directions Write a Review

NPPES record last updated: November 22, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinic/Center
  • Primary Care
  • CLIA Number: 44D2271402
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 11-01-2026

About MICHAEL WALL, PC

This page provides the complete NPI Profile along with additional information for Michael Wall, Pc, a primary care provider established in Maryville, Tennessee operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1023727633 assigned on November 2022. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Michael Wall Pa (Owner)

NPI
1023727633 Verify this NPI
Provider Name
MICHAEL WALL, PC
Entity Type
Organization
Location Address
362 HIGH ST MARYVILLE, TN 37804
Location Phone
(865) 413-1589
Location Fax
(865) 205-9475
Mailing Address
PO BOX 5777 MARYVILLE, TN 37802
Mailing Phone
(865) 246-2104
Mailing Fax
(865) 246-2106
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-22-2022
Last Update Date
11-22-2022
Code Navigator

A primary care provider (PCP) like Michael Wall, Pc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MICHAEL WALL PA

Authorized Official Title
OWNER
Authorized Official Phone
(865) 995-4643

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
44D2271402
Facility Type
Practitioner Other
Certificate Effective Date
November 02, 2024
Certificate Expiration Date
November 01, 2026
Laboratory Director
MICHAEL D. WALL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Michael Wall, Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MICHAEL WALL, PC

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023727633, enumerated as an "organization" on November 22, 2022.

The provider is located at 362 HIGH ST MARYVILLE, TN 37804 and the phone number is (865) 413-1589.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.