CAROL ANN WALLACE (NPI# 1639272412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639272412 |
| Entity Type | Individual |
| Full Name | CAROL ANN WALLACE |
| Other Name | CAROL ANN SMITH |
| Credential | MD |
| Practice Address |
10180 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Mailing Address |
2220 Ne 32nd Ave Portland OR 97212-5108 |
| Practice Telephone | 5036522880 |
| Mailing Telephone | 5032826611 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | MD14314 | OR | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111728 | Carol Wallace | Licensed Practical Nurse | 1052 Archer Pl, Baldwin, NY 11510-3604 | 2018-04-10 |
| 1912022492 | Carol L Wallace | Marriage & Family Therapist | 2376 Maritime Dr, Suite 200, Elk Grove, CA 95758 | 2007-03-21 |
| 1780921643 | Carol S Wallace | Pharmacist | 2774 N Cobb Pkwy, Kennesaw, GA 30152-3469 | 2013-01-12 |
| 1104107838 | Carol Henshaw Wallace | Pharmacist | 1201 Dinah Shore Boulevard, Bennetts Pharmacy, Winchester, TN 37398 | 2011-09-08 |
| 1497996623 | Carol Wallace | Social Worker | 1270 Doris Rd, Auburn Hills, MI 48326-2617 | 2009-03-18 |
| 1639348121 | Carol L. Wallace | Occupational Therapist | 7235 Whipple Ave Nw, North Canton, OH 44720-7137 | 2008-02-28 |
| 1790845006 | Carol Seeburger Wallace | Counselor | 220 W Ellsworth St, Midland, MI 48640-5180 | 2006-12-11 |
| 1639250996 | Carol A Wallace | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-10-17 |
| Street Address |
10180 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1588270466 | Jacob Aaron Stutheit | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-16 |
| 1023633005 | Jeremy Ward | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-06-15 |
| 1336761998 | Maksim Ivan Yablonsky | Technician, Other | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-05-17 |
| 1497389811 | Clifford Andrew Moore | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-25 |
| 1417580622 | Taryn Dee | Surgery | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-16 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1760022461 | Katie Keim | Social Worker | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-01-09 |
| 1346887668 | Hannah N. Schroeder | Registered Nurse | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-12-05 |
| 1164072286 | Thien-huong Theresa Van | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346336120 | Alf Edward Wyller | Health Maintenance Organization | 10100 Sw Sunnyside Rd., Clackamas, OR 97015 | 2006-10-05 |
| 1477662153 | Kaiser Permanente Nw Region | Health Maintenance Organization | Kaiser Foundation Health Plan of The Northwest, Mt, Tal, 10100 Se Sunnyside Road, Clackamas, OR 97015-9764 | 2006-08-29 |
| 1982032124 | Kaiser Permanente | Health Maintenance Organization | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5743 | 2013-10-25 |
| 1578721486 | Kaiser Permanente | Health Maintenance Organization | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2008-05-28 |
| 1487667887 | Wendy L. Mednick | Health Maintenance Organization | 9800 Se Sunnyside Rd, Kaiser Permanente Mt Scott Medical Office, Clackamas, OR 97015-9750 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073061859 | Logan Calahan | Health Maintenance Organization | 5028 Cumberland Ct Se, Salem, OR 97306-2011 | 2016-09-21 |
| 1306394796 | Rejuven8 Massage and Float Therapy, LLC | Health Maintenance Organization | 249 Liberty St Ne # B60, Salem, OR 97301-3503 | 2016-09-14 |
| 1043767445 | Kaiser Permanente | Health Maintenance Organization | 5381 W Baseline Rd, Hillsboro, OR 97123-6447 | 2016-09-02 |
| 1346607751 | Atrio Health Plans, Inc. | Health Maintenance Organization | 2270 Nw Aviation Dr Ste 3, Roseburg, OR 97470-2077 | 2016-01-15 |
| 1447624663 | Western Psychological and Counseling Services PC | Health Maintenance Organization | 22070 Ne Chinook Way, Fairview, OR 97024-2647 | 2015-11-26 |
| 1548645872 | Benjamin Murphy Lmt | Health Maintenance Organization | 2516 Ne Clackamas St, Portland, OR 97232-1727 | 2015-07-28 |
| 1467835520 | En8 Pain Management | Health Maintenance Organization | 1803 Lansing Ave Ne, Salem, OR 97301-8733 | 2015-07-07 |
| 1922490739 | Molly Hamilton Lmt | Health Maintenance Organization | 9415 Sw 125th Ave Apt 2, Beaverton, OR 97008-4045 | 2015-03-03 |
| 1609268556 | Kaiser Permanente | Health Maintenance Organization | 19748 S Sprague Rd, Oregon City, OR 97045-9640 | 2015-03-02 |
| 1982012662 | Muscle and Movement Therapy | Health Maintenance Organization | 5940 Se 138th Pl, Portland, OR 97236-4402 | 2014-07-26 |
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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.