MR. SCOTT ARTHUR WALLACE


Address: 3643 N Roxboro St, Durham Regional Hospital Emergency Department, Durham, NC 27704-2702
Phone: 9194705345

MR. SCOTT ARTHUR WALLACE (NPI# 1265613855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265613855
Entity Type Individual
Full Name MR. SCOTT ARTHUR WALLACE
Credential PA-C
Practice Address 3643 N Roxboro St
Durham Regional Hospital Emergency Department
Durham
NC 27704-2702
Mailing Address Po Box 15133
Durham
NC 27704-0133
Practice Telephone 9194705345
Mailing Telephone 9194705345
Enumeration Date 2007-11-25
Last Update Date 2012-06-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 0010-01140 NC Physician Assistants & Advanced Practice Nursing Providers

Other Providers SCOTT WALLACE

NPI Name Taxonomy Address Enumeration
1275809899 Scott Andrew Wallace Student in an Organized Health Care Education/Training Program Navy Medicine Support Command Attn: Med Staff Services, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 2012-03-28
1184996399 Scott D Wallace Social Worker 63 Glenwood St, Lowell, MA 01852-3007 2012-02-02
1629139563 Scott Matthew Wallace Chiropractor 8960 W Cheyenne Ave, Suite 110, Las Vegas, NV 89129-8929 2006-12-13
1770655342 Scott G Wallace Chiropractor 2515 Crosby Ave, Klamath Falls, OR 97603-4553 2006-11-15
1558381822 Scott Christopher Wallace Anesthesiology Po Box 112, Muncie, IN 47308-0112 2006-07-20
1831611839 Scott Christopher Wallace Nurse Practitioner 1900 S Main St, Findlay, OH 45840-1214 2017-07-11
1104359975 Scott Robert Wallace Psychiatry & Neurology 103 N Loop 499, Harlingen, TX 78550-2557 2017-04-07
1922441880 Scott Michael Wallace Pediatrics 75 Pringle Way, Ste 300, Reno, NV 89502-1464 2013-04-10
1134414220 Scott Eric Wallace Pharmacist 1214 N Market Blvd, Suite C, Sacramento, CA 95834-2931 2011-06-16
1568755114 Scott Wallace Technician, Other 4801 Reading St, Dallas, TX 75247-6716 2011-05-16

Office Location

Street Address 3643 N ROXBORO ST
DURHAM REGIONAL HOSPITAL EMERGENCY DEPARTMENT
City DURHAM
State NC
Zip Code 27704-2702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033113899 Nirmish Shah Internal Medicine 3643 N Roxboro St, Durham, NC 27704-2702 2005-06-09
1548872633 Christopher James Rogge Nurse Anesthetist, Certified Registered 3643 N Roxboro St, Durham, NC 27704-2702 2020-08-19
1801404579 Grace L Johnson Physician Assistant 3643 N Roxboro St, Durham, NC 27704-2702 2020-07-20
1174147102 Kaitlyn Elizabeth Cockerham Physician Assistant 3643 N Roxboro St, Durham, NC 27704-2702 2020-06-05
1306466859 Keri Laurelle Konstant Registered Nurse 3643 N Roxboro St, Durham, NC 27704-2702 2020-04-24
1194351262 Deidre Pelletier Physician Assistant 3643 N Roxboro St, Durham, NC 27704-2702 2020-03-20
1720618812 Elizabeth Parker Sulentic Nurse Practitioner 3643 N Roxboro St, Durham, NC 27704-2702 2020-01-17
1265079131 Melinda Yvonne House Nurse Practitioner 3643 N Roxboro St, Durham, NC 27704-2702 2019-12-10
1427607811 Grace Amy Revenaugh Dreyer Physician Assistant 3643 N Roxboro St, Durham, NC 27704-2702 2019-09-09
1841848934 Ann Mei Lin Hospitalist 3643 N Roxboro St, Durham, NC 27704-2702 2019-08-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245723139 Devang Ashokbhai Patel Dentist 2609 N Duke St Ste 618, Durham, NC 27704 2018-06-14
1891201042 Little Family Care Home, LLC Custodial Care Facility 1012 Davinci Street, Durham, NC 27704 2017-12-26
1033625702 Tondra A Little Social Worker 2804 Nellowood Street, Durham, NC 27704 2017-12-18
1437502408 Jhazmere Shamas Preston Counselor 2609 N. Duke St. Suite 403, Durham, NC 27704 2016-07-14
1649626656 Professional Elevations Pllc Case Manager/Care Coordinator 304 Crutchfield Drive, Durham, NC 27704 2016-05-09
1083071617 Alyssa Wilson Speech-Language Pathologist 215 William Penn Plz Apt 908, Durham, NC 27704 2016-01-27
1932565124 Arthur Reynolds Jr and Associates P.l.l.c. Dentist 2106 N Duke St, Durham, NC 27704 2016-01-05
1962877720 Chimere Brooks Contractor 4001meriwether Drive Apt P-19, Durham, NC 27704 2015-12-04
1184013294 Danielle King Physician Assistant 3611 N Duke Street, Durham, NC 27704 2015-01-13
1730581901 Images, 'of Me To You' Community/Behavioral Health 2823 Cascadilla Street, Durham, NC 27704 2014-09-19
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689281933 Kathryn Tarulli Physician Assistant 600 W Main St Apt 624, Durham, NC 27701-5005 2020-09-29
1801402896 Kristy Marie Stevlingson Physician Assistant 2211 Hillsborough Rd Apt 4081, Durham, NC 27705-4163 2020-09-16
1700490877 Alice Curchin Physician Assistant 813 N Buchanan Blvd Apt 4, Durham, NC 27701-1563 2020-09-04
1366056434 Katherine Monjaras Physician Assistant 2901 Bertland Ave Apt 1538, Durham, NC 27705-6829 2020-09-04
1659980233 Belinda Kim Khou Physician Assistant 501 Willard St Apt 215, Durham, NC 27701-3285 2020-07-29
1568080943 Katherine Jean Hauler Physician Assistant 3802 Meriwether Dr Apt L, Durham, NC 27704-2855 2020-07-11
1114554094 Lauren Michelle Grosse Physician Assistant Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 2020-03-23
1225668536 Ashley Lynn Biggs Physician Assistant 4302 Waterford Valley Dr Apt 1911, Durham, NC 27713-8353 2020-01-26
1710546007 Lauren Deruyter Physician Assistant 40 Duke Medicine Cir # 3j, Durham, NC 27710-4000 2019-06-10
1295202505 Nathaniel Quinley Physician Assistant Duke Clinic 40 Duke Medicine Circle, Durham, NC 27710-0001 2018-10-25
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Competitor

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City DURHAM
Zip Code 27704

Improve Information

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Dataset Information

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.

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