WALLACE E JOHNSON (NPI# 1902833619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902833619 |
| Entity Type | Individual |
| Full Name | WALLACE E JOHNSON |
| Credential | MD |
| Practice Address |
800 Ayrault Rd Ste 200 Fairport NY 14450-8941 |
| Practice Telephone | 5856022300 |
| Practice Fax Number | 5854252750 |
| Mailing Telephone | 5856022300 |
| Mailing Fax Number | 5854252750 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 200706 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01688146 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932355229 | Wallace B Johnson | Dentist | West Lake Road, Mayville, NY 14757-0126 | 2008-08-18 |
| 1639341076 | Wallace Emanuel Johnson | Orthopaedic Surgery | 273 Leeward Ct, Detroit, MI 48207-5053 | 2008-03-26 |
| 1346209020 | Wallace Scott Johnson | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2006-03-21 |
| 1659480838 | Wallace Allen Johnson Jr. | Pharmacist | 933 Old Rockford St, Suite 3, Mount Airy, NC 27030-5356 | 2006-08-30 |
| 1043253867 | Wallace R Johnson | Internal Medicine | 22 S Greene St, Baltimore, MD 21201-1590 | 2006-06-13 |
| Street Address |
800 AYRAULT RD STE 200 |
| City | FAIRPORT |
| State | NY |
| Zip Code | 14450-8941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972539351 | Patrick M Nunno | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-06-25 |
| 1366920274 | Jessica Hogestyn | Registered Nurse | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2018-08-02 |
| 1164563110 | Ronald Guzman | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2007-02-11 |
| 1457367153 | Lisa C Schwartz | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-08-01 |
| 1871523407 | Karen M Chruscicki | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-07-03 |
| 1346277050 | James M Mason | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982255899 | Stephanie Janet Catlin-rakoski | Counselor | 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 | 2019-09-23 |
| 1477011773 | Meredith Noel Austin-appleton | Pediatrics | Pediatric Urgent Care of Rochester, 6687 Pittsford Palmyra Rd, Fairport, NY 14450 | 2019-03-05 |
| 1659852358 | Linda Demme | Registered Nurse | 29 Pleasant St, Fairport, NY 14450 | 2018-08-22 |
| 1679075154 | Tharaha Thavakumar | Behavior Technician | 6 N. Main Street, Fairport, NY 14450 | 2018-03-01 |
| 1295244309 | Comprehensive Medicine, Pllc | Psychiatry & Neurology | 762 Crosskeys Office Park, Fairport, NY 14450 | 2017-09-21 |
| 1104353846 | Courtney Chapman | Student in an Organized Health Care Education/Training Program | 4 Valais Ct, Fairport, NY 14450 | 2017-05-12 |
| 1477947786 | Preston Orthodontics, Pllc | Dentist | 2154 Fairport Nine Mile Point Road, Fairport, NY 14450 | 2015-03-25 |
| 1154724334 | Amanda Corrisa Kalsih | Registered Nurse | 95 Evergreen Circle, Fairport, NY 14450 | 2014-10-02 |
| 1295172153 | Pamela Lea Alexander | Skilled Nursing Facility | 41 O,connor Road, Monroe #1 Boces, Fairport, NY 14450 | 2013-05-31 |
| 1255682084 | Lauren Lashomb | Specialist | 6 North Main Street, Fairport, NY 14450 | 2012-09-19 |
| Find all providers in zip 14450 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851597942 | Joyce Chu | Internal Medicine | 26 Mc Coord Woods Dr, Fairport, NY 14450-3848 | 2007-06-25 |
| 1043362155 | Bahram Dowlatshahi | Internal Medicine | 6780 Pittsford- Palmyra Road - 3b, Fairport, NY 14450 | 2007-01-17 |
| 1447331855 | David Jacob Bressler | Internal Medicine | 800 Ayrault Rd, Suite 200, Fairport, NY 14450-8941 | 2006-10-18 |
| 1639194533 | Northwestern Finger Lakes Medical | Internal Medicine | 1890 Sweets Corners Rd, Fairport, NY 14450-9141 | 2006-07-12 |
| 1972539351 | Patrick M Nunno | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-06-25 |
| 1093779043 | Anthony Solazzo | Internal Medicine | 710 Cross Keys Office Park, Fairport, NY 14450-3512 | 2006-04-14 |
| 1154385839 | Anthony C Sorge | Internal Medicine | 14 Pleasant St, Fairport, NY 14450 | 2006-04-12 |
| 1306808696 | Christine Stewart | Internal Medicine | 97 Harvest Rd, Fairport, NY 14450-2832 | 2006-04-04 |
| 1659330108 | Dewey Thomas Jackson | Internal Medicine | 2828 Baird Rd, Fairport, NY 14450-1247 | 2006-03-22 |
| 1134198849 | David William Kopp | Internal Medicine | 420 Cross Keys Office Park, Fairport, NY 14450-3506 | 2006-03-15 |
| Find all providers in FAIRPORT | ||||
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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.