JENNIFER WALLACE (NPI# 1124551247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124551247 |
| Entity Type | Individual |
| Full Name | JENNIFER WALLACE |
| Practice Address |
2100 Exeter Rd Germantown TN 38138-3966 |
| Mailing Address |
Po Box 405827 Atlanta GA 30384-5800 |
| Practice Telephone | 9017571350 |
| Practice Fax Number | 9017573496 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1977 | TN | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1295083897 | Jennifer Wallace | Psychologist | 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 | 2012-08-29 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| Street Address |
2100 EXETER RD |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38138-3966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031347 | Benjamin Louis Beatus | Psychiatry & Neurology | 2100 Exeter Rd, Germantown, TN 38138-3922 | 2005-05-23 |
| 1356997621 | Meghan Mincey | Occupational Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2019-08-13 |
| 1578118543 | Dustin Blaine Martin | Physical Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2019-08-07 |
| 1154891992 | Jennifer Elizabeth Ladmirault | Speech-Language Pathologist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2018-12-04 |
| 1518436609 | Sophie Deviney | Speech-Language Pathologist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2018-11-19 |
| 1588143317 | Allison Grace Carmichael | Occupational Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2018-08-13 |
| 1659873628 | Jacob Drew Gaskin | Physical Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2018-03-06 |
| 1336660422 | Leighanne Nicole Otten | Physical Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2017-06-29 |
| 1841710126 | Lauren Brooke Williamson | Physical Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2017-06-27 |
| 1861938649 | Iluobe Onuora | Occupational Therapist | 2100 Exeter Rd, Germantown, TN 38138-3966 | 2017-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382281 | Bluff Medical Group | Nurse Practitioner | 1779 Kirby Parkway, Suite 1-212, Germantown, TN 38138 | 2020-10-07 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1386102796 | Moscow Group LLC | Pharmacy | 2013 Exeter Rd, Germantown, TN 38138 | 2019-03-05 |
| 1952811010 | Select | Counselor | 9045 Forest Centre Dr Ste 102, Germantown, TN 38138 | 2017-10-03 |
| 1033638994 | 901 Physical Therapy, Pllc | Physical Therapist | 2495 Regents Walk, Germantown, TN 38138 | 2017-09-12 |
| 1124552401 | Elite Dental Germantown Plc | Dentist | 9064 Corporate Gradens Drive, Germantown, TN 38138 | 2017-04-13 |
| 1740728880 | Christian C Haynes | Nurse Anesthetist, Certified Registered | 1900 Exeter Rd., Suite 210, Germantown, TN 38138 | 2017-02-09 |
| 1740644004 | Kimberly Brooke Scheidegger | Counselor | 9045 Forest Centre Way, Heartlife Professional Soul Care, Germantown, TN 38138 | 2016-04-12 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1952761876 | Jane Chin Wynn Yeoh | Orthopaedic Surgery | 1400 South Germantown Road, Germantown, TN 38138 | 2016-03-04 |
| Find all providers in zip 38138 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578069 | Erin Dragutsky | Dietitian, Registered | 7260 Corsica Dr, Germantown, TN 38138-1632 | 2020-11-03 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1285030437 | Scott Steininger | Dietitian, Registered | 16040 Bonniebank Ter, Germantown, MD 20874-3118 | 2014-11-17 |
| 1750707501 | Nancy L. Salaets | Dietitian, Registered | 12525 Hawks Nest Ln, Germantown, MD 20876-5999 | 2014-03-17 |
| 1114263050 | Amanda Michelle Carmichael | Dietitian, Registered | 7714 Poplar Ave, Suite #201, Germantown, TN 38138-3801 | 2012-12-21 |
| 1427298819 | Louise G Jacobson | Dietitian, Registered | 6567 Poplar Woods Cir S, # 1, Germantown, TN 38138-0640 | 2009-02-25 |
| 1073633236 | Joan C Connor | Dietitian, Registered | 9933 S Houston Way, Germantown, TN 38139-6942 | 2007-03-30 |
| 1447377056 | Jeanne Ellen Baxter | Dietitian, Registered | W160 N10674 Fieldstone Pass, Germantown, WI 53022 | 2007-03-26 |
| 1134743453 | Montana Bryan | Dietitian, Registered | 2215 West St Ste 100, Germantown, TN 38138-3874 | 2020-06-02 |
| 1114499365 | Philip Bobrowsky | Dietitian, Registered | 19801 Observation Dr, Germantown, MD 20876-4070 | 2018-12-28 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 38138 |
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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.