DR. JON T WALL MD
NPI 1528006491
Family Medicine in Salt Lake City, UT

Q: What is Jon Wall's NPI number?

The NPI number for Jon Wall is 1528006491. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Q: What is Jon Wall's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jon Wall was last updated on June 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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 June 03, 2006PECOS Enrolled

4624 HOLLADAY BLVD, SALT LAKE CITY, UT 84117(801) 277-2682(801) 277-2980 Get Directions Write a Review

NPPES record last updated: June 1, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Jon T Wall Md NPPES

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

DR. JON T WALL MD (NPI 1528006491) is an individual family medicine provider in Salt Lake City, Utah, licensed in Utah (76-159863-1205) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528006491

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JON T WALLCredential: MD

Location Address4624 HOLLADAY BLVDSalt Lake City, UT 84117-5206

Mailing Address4624 Holladay BlvdSalt Lake City, UT 84117-5206 · (801) 277-2682 · Fax (801) 277-2980

Phone(801) 277-2682

Fax(801) 277-2980

Sole ProprietorNo

Enumeration DateJune 3, 2006

Last NPPES UpdateJune 1, 2009

✔ NPI 1528006491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in UT · 76-159863-1205

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4624 HOLLADAY BLVD, Salt Lake City, UT 84117

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Other Identifiers 2

Medicare UPIND07861UT

Medicare PINU000005441UT

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jon T Wall 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

VICKI L JACKMAN APRN

Nurse Practitioner