AMY CATHERINE WALLACE (NPI# 1376695627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376695627 |
| Entity Type | Individual |
| Full Name | AMY CATHERINE WALLACE |
| Credential | O.T. |
| Practice Address |
2920 Ronald Reagan Blvd Ste 110 Cumming GA 30041 |
| Practice Telephone | 7708890885 |
| Practice Fax Number | 7708800886 |
| Mailing Telephone | 7708890885 |
| Mailing Fax Number | 7708800886 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2013-12-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | OT004063 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225XH1200X |
Occupational Therapist Specialization: Hand |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 899040116A | 05 | |
| TRICARE NUMBER | 611446156001 | 01 | |
| GA | BCBS | 1376695627 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922472455 | Amy Wallace | Nurse Practitioner | 333 Portage St, Kalamazoo, MI 49007-4931 | 2015-11-20 |
| 1760887657 | Amy Wallace | Case Manager/Care Coordinator | 34 Seals Dr, Monroe, NY 10950-3949 | 2014-11-04 |
| 1376958553 | Amy Wallace | Occupational Therapy Assistant | 741 Fenwick Rd, Hillsboro, OH 45133-6789 | 2014-06-25 |
| 1528362902 | Amy Vosburg Wallace | Counselor | 6814 Auburn Oak Trl, Humble, TX 77346-1366 | 2010-12-29 |
| 1861663122 | Amy Beth Wallace | Licensed Practical Nurse | 150 Gate House Trl, Henrietta, NY 14467-9559 | 2008-03-14 |
| 1831289917 | Amy Piatt Wallace | Speech-Language Pathologist | 238 Cureton St, Greenville, SC 29605-1031 | 2006-10-13 |
| 1134619463 | Amy Wallace | Emergency Medicine | 28050 Grand River Ave, Farmington Hills, MI 48336-5919 | 2018-05-11 |
| 1104178052 | Amy M Wallace | Nurse Practitioner | 800 Rose St, 4th Floor, Lexington, KY 40536-0001 | 2012-10-02 |
| 1043452063 | Amy Evelyn Wallace | Registered Nurse | 516 Nizhoni Blvd, Gallup, NM 87301-5748 | 2009-04-06 |
| 1740457209 | Amy Wallace | Obstetrics & Gynecology | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2008-05-14 |
| Street Address |
2920 RONALD REAGAN BLVD STE 110 |
| City | CUMMING |
| State | GA |
| Zip Code | 30041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497753701 | Joseph Rouw | Optometrist | 2920 Ronald Reagan Blvd, Ste 104, Cumming, GA 30041-6206 | 2005-07-11 |
| 1659789923 | Pediatric Vision Development Center of Forsyth | Optometrist | 2920 Ronald Reagan Blvd, Ste 104, Cumming, GA 30041-6206 | 2014-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 225XH1200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Hand |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326396136 | North Georgia Hand Therapy, LLC | Occupational Therapist | 765 Peachtree Pkwy, Suite 2, Cumming, GA 30041-9522 | 2012-08-28 |
| 1467917054 | Jacob Edward Paquet | Occupational Therapist | 100 Mountain View Dr Ste 100, Cumming, GA 30040-2434 | 2019-02-07 |
| 1225479058 | Shelly Marie Davidovich | Occupational Therapist | 1200 Northside Forsyth Dr, Cumming, GA 30041-7659 | 2013-07-09 |
| 1376712760 | Lisa Marie Mohesky | Occupational Therapist | 1100 Northside Forsyth Dr, Suite 340, Cumming, GA 30041-6012 | 2008-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548727506 | Sherry Easton Johnson | Occupational Therapist | 3850 Pleasant Hill Rd Unit 1, Duluth, GA 30096-4807 | 2019-02-26 |
| 1801387907 | Joseph Edward Shaw IIi | Occupational Therapist | 655 Molly Ln Ste 4, Woodstock, GA 30189-6503 | 2018-05-23 |
| 1821538216 | Ariana Madrid | Occupational Therapist | 2061 Peachtree Rd Ne Ste 450, Atlanta, GA 30309-1445 | 2017-03-03 |
| 1669915443 | Maria Isabel Posada | Occupational Therapist | 1285 Hembree Rd Ste 200, Roswell, GA 30076-5720 | 2016-11-28 |
| 1386031656 | Rachel Chariton | Occupational Therapist | 2300a Manchester Expy Ste 101b, Columbus, GA 31904-6812 | 2015-04-23 |
| 1356783757 | Hand Therapy Services, Inc. | Occupational Therapist | 5 Medical Dr Ne, Cartersville, GA 30121-8003 | 2013-07-25 |
| 1164765939 | Phyllis Nessell Denton | Occupational Therapist | 1851 Shoreline Trce, Grayson, GA 30017-1166 | 2013-03-31 |
| 1568746568 | Donna Hall-rosenthal | Occupational Therapist | 4510 Nelson Brogdon Blvd, Buford, GA 30518-3478 | 2011-10-10 |
| 1770746729 | Alexis Ventimglia Najarro | Occupational Therapist | 2061 Peachtree Road, Suite 500, Atlanta, GA 30309 | 2008-07-09 |
| 1932306305 | Holley Hand Therapy, Inc. | Occupational Therapist | 140 Vann St Ne Ste 430, Marietta, GA 30060-7297 | 2007-06-29 |
| Find all providers with the same taxonomy | ||||
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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.