ERIK J WALLACE (NPI# 1639451651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639451651 |
| Entity Type | Individual |
| Full Name | ERIK J WALLACE |
| Credential | LAT |
| Practice Address |
50 Sherry Ave Park Falls WI 54552-1467 |
| Mailing Address |
1000 N Oak Ave Marshfield WI 54449-5703 |
| Practice Telephone | 7157623212 |
| Mailing Telephone | 7153875511 |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1296 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477523843 | Erik Allen Wallace | Internal Medicine | 4444 E 41st St, 3rd Floor, Ste A, Tulsa, OK 74135-2527 | 2006-01-26 |
| Street Address |
50 SHERRY AVE |
| City | PARK FALLS |
| State | WI |
| Zip Code | 54552-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952393720 | James William Nesbit | Specialist/Technologist | 50 Sherry Ave, Marshfield Clinic, Park Falls, WI 54552-1467 | 2005-08-18 |
| 1528696168 | Rachael Johnston | Physician Assistant | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2020-03-30 |
| 1376071787 | Cassy Susan Pydo | Physician Assistant | 50 Sherry Ave, Park Falls, WI 54552 | 2017-05-30 |
| 1689089112 | Raj Purshotam Hiranandani | Internal Medicine | 50 Sherry Ave, Park Falls, WI 54552 | 2014-06-23 |
| 1588095806 | Alice Schmutzler | Nurse Practitioner | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2013-12-12 |
| 1124462163 | Family Health Center of Marshfield, Inc. | Durable Medical Equipment & Medical Supplies | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2013-04-22 |
| 1710232137 | Lori H. Sharrow | Nurse Practitioner | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2012-07-23 |
| 1114162666 | Yusuf Kasirye | Internal Medicine | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2008-12-12 |
| 1104082452 | Debra L. Ciasulli | Internal Medicine | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2008-08-05 |
| 1295930394 | Richard A. Anderson | Nurse Practitioner | 50 Sherry Ave, Park Falls, WI 54552-1467 | 2007-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891178794 | Diana Jane Elizabeth Doyle | Dentist | 244 Division St, Park Falls, WI 54552 | 2015-07-09 |
| 1285811513 | Jenna May Peterson | Hearing Instrument Specialist | 698 4th Ave S, Park Falls, WI 54552 | 2008-01-29 |
| 1164609038 | Dennis Jerome Beyer | Hearing Instrument Specialist | 177 Division St, Miracle Ear, Park Falls, WI 54552 | 2008-01-23 |
| 1649459348 | Chequamegon School District | Local Education Agency (LEA) | 420 9th St N, Park Falls, WI 54552 | 2007-10-30 |
| 1265517593 | Daniel L Marsh | Dentist | 1001 N First Avenue, Park Falls, WI 54552 | 2006-10-26 |
| 1487724803 | Redman & Gelinas S C | Eyewear Supplier (Equipment, not the service) | 698 S 4th Ave, Park Falls, WI 54552-1125 | 2006-11-09 |
| 1689677999 | Park Pharmacy Inc | Pharmacy | 138 2nd Ave N, Park Falls, WI 54552-1214 | 2005-05-31 |
| 1316940679 | Park Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 138 1/2 2nd Ave N, Park Falls, WI 54552-1214 | 2005-05-31 |
| 1013194992 | Peggy Ann Prohaska | Pharmacist | 138 2nd Ave N, Park Falls, WI 54552-1214 | 2008-01-23 |
| 1952588774 | Mark Steven Pechacek | Pharmacist | 138 2nd Ave N, Park Falls, WI 54552-1214 | 2008-01-23 |
| Find all providers in zip 54552 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952393720 | James William Nesbit | Specialist/Technologist | 50 Sherry Ave, Marshfield Clinic, Park Falls, WI 54552-1467 | 2005-08-18 |
| 1922296045 | Back-n-action Physical Therapy and Rehab Specialists | Specialist/Technologist | 500 Birch St, Park Falls, WI 54552-1415 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1184222085 | Ryan James Mcnamara | Specialist/Technologist | 28914 Golden Cir, Waterford, WI 53185-1197 | 2020-10-13 |
| 1770198699 | Tanner Sterling | Specialist/Technologist | 2538 E Garrison Rd, Foxboro, WI 54836-9507 | 2020-09-09 |
| 1922626670 | Eric William Brostrom | Specialist/Technologist | 3305 Lilly Rd, Brookfield, WI 53005-7608 | 2020-07-09 |
| 1174146690 | Brycen Valiga | Specialist/Technologist | 4477 S 113th St, Greenfield, WI 53228-2566 | 2020-05-19 |
| 1104448307 | Xeing Randy Yang | Specialist/Technologist | 2207 Namekagon St, Hudson, WI 54016-9426 | 2020-05-11 |
| 1073134615 | Brian Wood | Specialist/Technologist | 1950 Washington St, Grafton, WI 53024-2103 | 2020-05-06 |
| 1124649751 | Cody Scott Tesch | Specialist/Technologist | 6680 N Teutonia Ave, Milwaukee, WI 53209-3117 | 2020-05-05 |
| 1659992642 | Kelley Potila | Specialist/Technologist | 255 Maggilu Ct, Jefferson, WI 53549-2095 | 2020-04-30 |
| 1366070708 | Claire Duwell | Specialist/Technologist | 9111 W Bluemound Rd, Milwaukee, WI 53226-4506 | 2020-03-31 |
| Find all providers with the same taxonomy | ||||
| City | PARK FALLS |
| Zip Code | 54552 |
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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.