DR. NICOLE MARIE WALLIS (NPI# 1346443728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346443728 |
| Entity Type | Individual |
| Full Name | DR. NICOLE MARIE WALLIS |
| Credential | MD |
| Practice Address |
1 Perkins Sq Akron Children's Hospital Akron OH 44308 |
| Mailing Address |
2500 Metrohealth Dr Cleveland OH 44109-1900 |
| Practice Telephone | 3305438452 |
| Mailing Telephone | 2167787800 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35089618 | OH | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154409357 | Nicole Lynn Wallis | Licensed Practical Nurse | 421 East 1st Street, Wellston, OH 45692 | 2006-11-02 |
| Street Address |
1 PERKINS SQ AKRON CHILDREN'S HOSPITAL |
| City | AKRON |
| State | OH |
| Zip Code | 44308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043216468 | Kerry Leone-quisenberry | Nurse Anesthetist, Certified Registered | 1 Perkins Sq, Akron, OH 44308-1063 | 2005-06-21 |
| 1639778681 | Megan Susanne Foster | Nurse Practitioner | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-10-21 |
| 1639781800 | Danielle Marie Standohar | Pediatrics | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-08-19 |
| 1548872039 | Brooke N Phillips | Nurse Practitioner | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-08-18 |
| 1609494517 | Angela Marie Corsi | Nurse Practitioner | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-07-07 |
| 1124647516 | Marisa M Mancuso | Student in an Organized Health Care Education/Training Program | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-04-15 |
| 1235768870 | Elizabeth Suzanne Mcinturf | Student in an Organized Health Care Education/Training Program | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-04-06 |
| 1447889142 | Kaitlin Minotti | Student in an Organized Health Care Education/Training Program | 1 Perkins Sq, Akron, OH 44308-1062 | 2020-04-04 |
| 1790314813 | Spencer Jeffrey Gasser | Student in an Organized Health Care Education/Training Program | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-04-02 |
| 1992334080 | Rachel Worth | Registered Nurse | 1 Perkins Sq, Akron, OH 44308-1063 | 2020-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285267096 | Terrence Shambley | Specialist/Technologist | 333 S Mainst Suite 607, Akron, OH 44308 | 2020-02-20 |
| 1750865028 | Christian Bates | Case Manager/Care Coordinator | 333 S.main Street, Akron, OH 44308 | 2018-09-21 |
| 1558854471 | Sheryl Alyssa Mendoza | Case Manager/Care Coordinator | 333 S Main St Ste 607333, Akron, OH 44308 | 2018-06-14 |
| 1033608260 | Angela Leigh Capuano Fant | Student in an Organized Health Care Education/Training Program | 340 South Broadway Street, Akron, OH 44308 | 2018-05-03 |
| 1639686918 | Crystal Louise Mann | Counselor | 90 N Summit St, Akron, OH 44308 | 2018-01-08 |
| 1174074173 | Jameela Hawkins | Counselor | 333 S Main St Ste 607, Akron, OH 44308 | 2016-10-14 |
| 1164817219 | Elizabeth Theresa Stephens | Pediatrics | 214 W Bowery St, Akron, OH 44308 | 2015-04-04 |
| 1407105596 | Rebecca Wasserman Lieb | Psychologist | 215 W. Bowery Street, Consodine Professional Building, Akron, OH 44308 | 2012-09-05 |
| 1871895573 | Crystal Joyce | Pediatrics | 1 Perkins Sqaure, Medical Education, Akron, OH 44308 | 2010-12-01 |
| 1508000431 | Emily Lee Wiland | Pediatrics | 177 West Exchange Street, 6th Floor Room 61118, Akron, OH 44308 | 2009-04-22 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528695384 | Chizite Iheonunekwu | Emergency Medicine | 1 Akron General Ave # Aae, Akron, OH 44307-2432 | 2020-03-23 |
| 1861922353 | Nicholas Lafountain | Emergency Medicine | 524 E Market St, Akron, OH 44304 | 2017-06-15 |
| 1831596600 | Mark A Medvedeff | Emergency Medicine | 540 Barwell St, Akron, OH 44303-1949 | 2014-11-22 |
| 1649513581 | Ginny Lee | Emergency Medicine | 684 S Hawkins Ave, Akron, OH 44320-1870 | 2013-03-28 |
| 1538397708 | Christopher M Fridrich | Emergency Medicine | 320 Village Pointe Dr, Apartment J, Akron, OH 44313-7446 | 2009-06-26 |
| 1396959672 | Timothy Carmalt Matlack Jr. | Emergency Medicine | 525 East Market St, Akron, OH 44309-2090 | 2007-05-09 |
| 1558447094 | Gordon L. Zellers | Emergency Medicine | 1930 N Cleveland Massillon Rd, Akron, OH 44333-1817 | 2006-10-27 |
| 1467556035 | Michael John Saddleton | Emergency Medicine | 1070 Merriman Rd, Akron, OH 44303-1767 | 2006-09-12 |
| 1639157332 | Martin G Hellman | Emergency Medicine | 515 Woodbury Dr, Akron, OH 44333-2782 | 2006-01-04 |
| 1891778403 | Bradley Joseph Clarke | Emergency Medicine | 4040 Embassy Pkwy Ste 370, Akron, OH 44333-8372 | 2005-11-29 |
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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.