DR. JAMES EDWARDS WALLACE JR. (NPI# 1063464006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063464006 |
| Entity Type | Individual |
| Full Name | DR. JAMES EDWARDS WALLACE JR. |
| Credential | MD |
| Practice Address |
1135 Expressway Dr Suite 200 A Pineville LA 71360-6698 |
| Practice Telephone | 3185619600 |
| Practice Fax Number | 3185610228 |
| Mailing Telephone | 3185619600 |
| Mailing Fax Number | 3185610228 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-06-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD.200134 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | UNITED HEALTHCARE | 202768397 | 01 |
| LA | HUMANA MILITARY | 202768397 | 01 |
| LA | HUMANA | 202768397 | 01 |
| LA | 1627950 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226005 | James D Wallace | Technician | 67 Don Dale Dr, Foster, WV 25081 | 2020-08-20 |
| 1982173571 | James Preston Wallace II | Clinic/Center | 6234 Castlegate Dr W Apt 8112, Castle Rock, CO 80108-8655 | 2018-11-13 |
| 1356686877 | James Steven Wallace | Physical Therapy Assistant | 449 Main St Apt 131, Anderson, IN 46016-1186 | 2012-12-10 |
| 1033400999 | James Wallace | Durable Medical Equipment & Medical Supplies | 593 Bramlett Way, Powder Springs, GA 30127 | 2011-04-27 |
| 1841591559 | James Leeman Wallace | Massage Therapist | 29650 Sw Courtside Dr, #14, Wilsonville, OR 97070-7482 | 2010-11-11 |
| 1992023212 | James Joseph Wallace | Specialist | 154 Sugar Cane Dr, Hartwell, GA 30643-8120 | 2010-05-11 |
| 1538338413 | James Christopher Wallace | Military Health Care Provider | Uss Ross, Ddg 71, Fpo, AE 09586-1288 | 2008-02-26 |
| 1568664274 | James Christopher Wallace | Emergency Medical Technician, Basic | Cgc Chase (whec-718) Fpo Ap 96662-3932 32nd St, San Diego, CA 92106 | 2007-06-04 |
| 1760683924 | James G Wallace Jr. | Family Medicine | 525 Jay Ave, Brewster, WA 98812-3403 | 2007-05-29 |
| 1922143882 | James B Wallace Jr. | Dentist | 6618 Fm 2100, Crosby, TX 77532 | 2007-02-20 |
| Street Address |
1135 EXPRESSWAY DR SUITE 200 A |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360-6698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740626274 | Eric Lee Ingram | Physical Therapist | 1135 Expressway Dr, Suite 100 B, Pineville, LA 71360-6653 | 2013-05-10 |
| 1912260480 | William David Prestridge | Physical Therapist | 1135 Expressway Dr, Suite 100, Pineville, LA 71360-6653 | 2012-06-20 |
| 1407164866 | Caroline Elisabeth Dessens | Physical Therapist | 1135 Expressway Dr, Suite 100-b, Pineville, LA 71360-6653 | 2010-09-20 |
| 1326236134 | Judith B. Nance, M.d. LLC | Family Medicine | 1135 Expressway Dr, Suite 200 A, Pineville, LA 71360-6698 | 2007-10-05 |
| 1568652485 | James E. Wallace, Jr, M.d., LLC | Family Medicine | 1135 Expressway Dr, Suite 200 A, Pineville, LA 71360-6698 | 2007-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
| Find all providers in zip 71360 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487046835 | Louisiana Quick Care LLC | Family Medicine | 12805 Highway 28 E Ste B, Pineville, LA 71360-0734 | 2015-02-23 |
| 1013204734 | Joanna Marie Adkins Bailey | Family Medicine | 585 Appalachian Highway, Pineville, WV 24874-0430 | 2011-07-01 |
| 1720264427 | Hugh D Washburn | Family Medicine | 7521 Highway 28 E, Pineville, LA 71360-9733 | 2008-01-14 |
| 1851420525 | Elk River Health Services, Inc. | Family Medicine | 5265 S Bus Hwy 71, Suite J, Pineville, MO 64856-0265 | 2007-03-05 |
| 1053488288 | Jonathan S Forester | Family Medicine | 2809 Donahue Ferry Rd, Pineville, LA 71360 | 2006-11-30 |
| 1376645820 | Uzvaltha Ganji | Family Medicine | 2495 Shreveport Hwy # Hwy.71north, Medical Cervise 111, Pineville, LA 71360-4044 | 2006-09-04 |
| 1366550279 | Dominador Yti Lao | Family Medicine | Rt 10 Appalachain Hwy. East Pineville, Pineville, WV 24874-1274 | 2006-08-29 |
| 1225067317 | Family Healthcare Associates Inc | Family Medicine | 113 Main Ave, Pineville, WV 24874-1650 | 2006-07-01 |
| 1295763928 | William Jackson Defee IIi | Family Medicine | 5507 Shreveport Hwy, Pineville, LA 71360-3533 | 2006-06-29 |
| 1609813807 | Shawn Shadell Fugate | Family Medicine | 313 S Cherry St, Pineville, KY 40977-1724 | 2006-05-31 |
| Find all providers in PINEVILLE | ||||
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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.