DR. RICHARD B WALLACE (NPI# 1457442477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457442477 |
| Entity Type | Individual |
| Full Name | DR. RICHARD B WALLACE |
| Credential | D.O. |
| Practice Address |
215 N 3rd St Leesburg FL 34748-5105 |
| Practice Telephone | 3523157900 |
| Practice Fax Number | 3523157587 |
| Mailing Telephone | 3523157900 |
| Mailing Fax Number | 3523157587 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
05-22572 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS | 052290 | 01 |
| KS | 100098100A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811434400 | Richard Wallace | Registered Nurse | 4905 Hackamore Dr N, Colorado Springs, CO 80918-2632 | 2017-01-20 |
| 1023242112 | Richard Lance Wallace | Physical Therapist | 1034 Buchanan Bridge Rd, Chesterfield, SC 29709-6154 | 2009-05-05 |
| 1063656262 | Richard Scott Wallace | Social Worker | 10625 Redmond Rd, Austin, TX 78739-1654 | 2009-05-01 |
| 1710105911 | Richard Franklin Wallace | Marriage & Family Therapist | 3341 M St, Merced, CA 95348-2714 | 2007-04-23 |
| 1326199043 | Richard J. Wallace | Counselor | 1930 Stuart St, Berkeley, CA 94703-2215 | 2007-01-16 |
| 1750458402 | Richard Dean Wallace | Nutritionist | 914 13th Ave South, Great Falls, MT 59405 | 2006-11-29 |
| 1427155001 | Richard Lange Wallace | Psychiatry & Neurology | 8858 Scenic Bay Dr, Las Vegas, NV 89117-1026 | 2006-09-17 |
| 1275586448 | Richard Peterkin Wallace | Family Medicine | 1001 S Fort Harrison Ave, Suite 101, Clearwater, FL 33756-3941 | 2006-05-18 |
| 1881656940 | Richard M. Wallace | Specialist | 925 Highland Blvd., Suite 1180, Bozeman, MT 59715 | 2006-04-04 |
| 1972596443 | Richard J Wallace | Dentist | 20921 E Smoky Hill Rd, Suite A, Centennial, CO 80015 | 2005-08-30 |
| Street Address |
215 N 3RD ST |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-5105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568019792 | Catherine Heflin | Case Manager/Care Coordinator | 215 N 3rd St, Leesburg, FL 34748-5105 | 2019-08-22 |
| 1629436282 | Amanda Neil | Registered Nurse | 215 N 3rd St, Leesburg, FL 34748-5105 | 2016-02-10 |
| 1235524067 | Sinead O'hare | Social Worker | 215 N 3rd St, Leesburg, FL 34748-5105 | 2015-03-30 |
| 1659613776 | Lifestream Behavioral Center Inc | Clinic/Center | 215 N 3rd St, Leesburg, FL 34748-5105 | 2013-03-27 |
| 1518256940 | Jessica Lee Beach | Social Worker | 215 N 3rd St, Leesburg, FL 34748-5105 | 2011-04-06 |
| 1518264316 | Cindy Edwards | Counselor | 215 N 3rd St, Leesburg, FL 34748-5105 | 2011-02-15 |
| 1679878599 | Krishniah Ramsetty | Psychiatry & Neurology | 215 N 3rd St, Leesburg, FL 34748-5105 | 2011-01-25 |
| 1487959078 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 215 N 3rd St, Leesburg, FL 34748-5105 | 2011-01-13 |
| 1679892616 | Kristie Johnson | Nurse Practitioner | 215 N 3rd St, Leesburg, FL 34748-5105 | 2010-05-28 |
| 1013232446 | Linda L Silverman | Counselor | 215 N 3rd St, Leesburg, FL 34748-5105 | 2010-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215311808 | Yasmin Banaei | Psychiatry & Neurology | 43106 Rocky Ridge Ct, Leesburg, VA 20176-1805 | 2015-07-14 |
| 1639414758 | Healthy Minds Psychiatry Services | Psychiatry & Neurology | 18341 Mid Ocean Pl, Leesburg, VA 20176-7477 | 2012-11-29 |
| 1053644526 | Inova Loudoun Hospital | Psychiatry & Neurology | 224 Cornwall St Nw # B, Leesburg, VA 20176-2701 | 2009-09-15 |
| 1912105750 | Tehmina M Sheikh | Psychiatry & Neurology | 102 Heritage Way,suite 302 Ne, Leesburg, VA 20176 | 2007-07-03 |
| 1457560864 | Vitaly G Steinberg | Psychiatry & Neurology | 4293 Route 47, Leesburg, NJ 08327-2010 | 2007-05-22 |
| 1750431433 | Nick Maron Ungson | Psychiatry & Neurology | 33057 Professional Dr, Suite 102, Leesburg, FL 34788-7506 | 2007-01-12 |
| 1750449245 | Donald Penn Hall Jr. | Psychiatry & Neurology | 44084 Riverside Parkway, 240, Leesburg, VA 20176 | 2006-12-05 |
| 1316962301 | Yar Mohammad | Psychiatry & Neurology | 102 Heritage Way Ne, Suite 302, Leesburg, VA 20176-4544 | 2006-07-12 |
| 1629033493 | Brad Broyles | Psychiatry & Neurology | 2018 Talley Rd, Leesburg, FL 34748-3426 | 2006-04-17 |
| 1518966126 | Juan Francisco Rios | Psychiatry & Neurology | 700 N Palmetto St, Leesburg, FL 34748-4419 | 2005-07-15 |
| Find all providers in LEESBURG | ||||
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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.