JENNIFER LYNN WALLS MD
NPI 1104138890
Pediatrics - Pediatric Emergency Medicine in Fort Myers, FL

Q: What is Jennifer Walls's NPI number?

The NPI number for Jennifer Walls is 1104138890. It was assigned to this individual provider in the NPPES registry on July 9, 2010. The provider is also known as Jennifer Walls M.D..

Q: What is Jennifer Walls's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Walls was last updated on March 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 09, 2010PECOS Enrolled

9981 S HEALTHPARK DR, FORT MYERS, FL 33908(239) 343-6260(239) 343-6259 Get Directions Write a Review

NPPES record last updated: March 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 30, 2021, Oct 28, 2020, Apr 7, 2020 and 1 more (4 updates tracked since 2018).

On this page

About Jennifer Lynn Walls Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER LYNN WALLS MD (NPI 1104138890) is an individual pediatric emergency medicine provider in Fort Myers, Florida, licensed in Florida (ME141875) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104138890

Entity TypeIndividualFemale

Primary Taxonomy2080P0204X

Provider Legal NameJENNIFER LYNN WALLSCredential: MD

Location Address9981 S HEALTHPARK DRFort Myers, FL 33908-3618

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-6260 · Fax (239) 343-6259

Phone(239) 343-6260

Fax(239) 343-6259

Sole ProprietorNo

Enumeration DateJuly 9, 2010

Last NPPES UpdateMarch 30, 20214 updates tracked since enumeration

NPPES CertifiedMarch 30, 2021

✔ NPI 1104138890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in FL · ME141875

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License 29629 (OK), E-11128 (AR), DR.0056229 (CO)

9981 S HEALTHPARK DR, Fort Myers, FL 33908

Open in Google Maps ↗

Other Names 1

Professional Name (2)Jennifer Walls M.d.

Other Identifiers 2

Medicaid103693300FL

Medicaid224991001AR

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Lynn Walls Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SREEDHAR GELLI M.D.

Hospitalist