DR. JAY WILLIAM WALLACE (NPI# 1659742716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659742716 |
| Entity Type | Individual |
| Full Name | DR. JAY WILLIAM WALLACE |
| Credential | PHARM. D. |
| Practice Address |
1616 Physicians Dr Tallahassee FL 32308-4619 |
| Practice Telephone | 8504315154 |
| Mailing Telephone | 8504315154 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835G0303X |
Pharmacist Specialization: Geriatric |
PS28349 | FL | Pharmacy Service Providers |
| Street Address |
1616 PHYSICIANS DR |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-4619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174580153 | Wayne Holt Denton | Psychiatry & Neurology | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2006-04-26 |
| 1437676780 | Courtney Nicole Willoughby | Counselor | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2017-08-28 |
| 1710328174 | Melissa Gael Murphy | Social Worker | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2013-07-15 |
| 1407195704 | Heather L. Lincicome | Social Worker | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2013-02-06 |
| 1033447099 | Caryl Marie Brady | Social Worker | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2009-12-02 |
| 1205161668 | Paul Robert Knoll | Counselor | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2009-10-02 |
| 1346488277 | Lisa Ann Traver-etheridge | Social Worker | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2009-01-30 |
| 1407041023 | Vicki Buzbee Burks | Counselor | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2007-09-06 |
| 1487848842 | Glenn August Graves | Social Worker | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2007-08-29 |
| 1194922286 | Sireesha Chimata | Psychiatry & Neurology | 1616 Physicians Dr, Tallahassee, FL 32308-4619 | 2007-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 1835G0303X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Geriatric |
| A pharmacist who is certified in geriatric pharmacy practice is designated as a "Certified Geriatric Pharmacist" (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly. |
| Notes: Source: Commission for Certification in Geriatric Pharmacy (www.ccgp.org) [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710256995 | Jonathan Michael Hickman | Pharmacist | 371 Milestone Dr, Tallahassee, FL 32312-3575 | 2011-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306475769 | Gianluca Gullo | Pharmacist | 6463 S Falkenburg Rd, Riverview, FL 33578-8696 | 2020-04-07 |
| 1336624576 | Herbert Nichols | Pharmacist | 1583 Pratt St, Deland, FL 32720-8445 | 2018-10-02 |
| 1174061048 | Kenneth Webster Fuqua Sr. | Pharmacist | 1122 Old Polk City Rd, Lakeland, FL 33809-6622 | 2017-02-10 |
| 1366989378 | Betsy Townsend | Pharmacist | 1075 Coastal Cir, Ocoee, FL 34761-4319 | 2017-01-28 |
| 1821485046 | Gretchen Mary Petrie | Pharmacist | 1255 Kasamada Dr, Fort Myers, FL 33919-1622 | 2015-04-26 |
| 1982090080 | Lissel Cruz | Pharmacist | 7030 Sw 8th St, Pembroke Pines, FL 33023-1636 | 2015-04-15 |
| 1164869426 | Reetesh Kumar Jaiswal | Pharmacist | 5214 Neil Dr, St Petersburg, FL 33714-2401 | 2013-05-28 |
| 1013266493 | Peter L Day | Pharmacist | 6447 Nw 55th St, Coral Springs, FL 33067-2709 | 2012-08-31 |
| 1205118148 | David Milstein | Pharmacist | 11831 Nw 25th St, Plantation, FL 33323-1701 | 2011-09-16 |
| 1104076215 | Maya Abby Myalil | Pharmacist | 3088 Country Club Blvd, Orange Park, FL 32073-5730 | 2008-09-25 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
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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.