AMY WALLACE (NPI# 1740457209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740457209 |
| Entity Type | Individual |
| Full Name | AMY WALLACE |
| Credential | M.D. |
| Practice Address |
1010 Bethesda Ct Winston Salem NC 27103-3019 |
| Mailing Address |
Po Box 75216 Charlotte NC 28275-0216 |
| Practice Telephone | 3362778800 |
| Mailing Telephone | 3362778800 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
2012-00695 | NC | Allopathic & Osteopathic Physicians |
| 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 |
| 1376695627 | Amy Catherine Wallace | Occupational Therapist | 2920 Ronald Reagan Blvd, Ste 110, Cumming, GA 30041 | 2007-01-17 |
| Street Address |
1010 BETHESDA CT |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-3019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245210707 | Piedmont Hematology-oncology Associates, Pllc | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2006-01-20 |
| 1497361455 | Dominika Bajguz | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2020-09-16 |
| 1003300609 | Daria Wuycik Wooten | Pharmacist | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-06-18 |
| 1083119366 | Sarah Caitlin Hughes | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-03-28 |
| 1104321470 | Erica Lynn Cousins | Genetic Counselor, MS | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2018-03-28 |
| 1215484340 | Novant Medical Group | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2016-09-07 |
| 1659737757 | Novant Medical Group, Inc | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2016-01-06 |
| 1649635954 | Novant Medical Group, Inc | Internal Medicine | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2015-12-31 |
| 1912348483 | Novant Medical Group Inc | Hospitalist | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2013-07-12 |
| 1083934343 | Elizabeth Miles Haynes | Physician Assistant | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2010-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528383163 | Janelle Pakish Darby | Obstetrics & Gynecology | Medical Center Blvd, Winston Salem, NC 27157 | 2010-04-06 |
| 1831331495 | William David Baker | Obstetrics & Gynecology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2009-03-29 |
| 1558314369 | Elizabeth N Skinner | Obstetrics & Gynecology | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2006-05-19 |
| 1114997285 | Lawrence Nycum | Obstetrics & Gynecology | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2006-01-23 |
| 1780654871 | Charles Pippitt | Obstetrics & Gynecology | 1010 Bethesda Ct, Winston Salem, NC 27103-3019 | 2006-01-23 |
| 1114907581 | Rolland J Barrett | Obstetrics & Gynecology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245596907 | Ama Buskwofie | Obstetrics & Gynecology | 215 William Penn Plz Apt 735, Durham, NC 27704-2555 | 2012-04-06 |
| 1184704264 | Wendy R. Brewster | Obstetrics & Gynecology | 3027 Old Clinic Bldg., Cb #7570, Dept. of Ob/gyn, Chapel Hill, NC 27599-7570 | 2006-10-16 |
| 1902846330 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 1918 Randolph Rd Ste 175, Charlotte, NC 28207-1107 | 2006-06-07 |
| 1508857962 | Michael John Sundborg | Obstetrics & Gynecology | 145 Applecross Rd, Southern Pines, NC 28388-0749 | 2005-11-03 |
| 1477171759 | The Presbyterian Hospital | Obstetrics & Gynecology | 125 Queens Rd Ste 540, Charlotte, NC 28204-3215 | 2020-07-13 |
| 1295385748 | Mcpc-20, LLC | Obstetrics & Gynecology | 220 Page Rd, Pinehurst, NC 28374-8748 | 2019-09-17 |
| 1093369530 | Novant Medical Group. Inc. | Obstetrics & Gynecology | 2290 Remount Rd, Gastonia, NC 28054-4725 | 2019-08-01 |
| 1386206951 | Rex Hospital Inc | Obstetrics & Gynecology | 4420 Lake Boone Trl Ste 201, Raleigh, NC 27607-7505 | 2019-07-03 |
| 1659936011 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 5701 W Friendly Ave, Greensboro, NC 27410-4112 | 2019-05-01 |
| 1194138925 | Lindsey Buckingham | Obstetrics & Gynecology | 101 Manning Dr, Chapel Hill, NC 27514-4220 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.