JACQUELINE M WALLACE (NPI# 1912945155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912945155 |
| Entity Type | Individual |
| Full Name | JACQUELINE M WALLACE |
| Credential | PHYSICIAN |
| Practice Address |
10910 Little Patuxent Pkwy Suite 100 Columbia MD 21044-3078 |
| Practice Telephone | 4109978444 |
| Mailing Telephone | 4109978444 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2010-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | D0069282 | MD | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | MD059921L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 101044156 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497743504 | Jacqueline D Wallace | Social Worker | 447 West St, Suite #3, Amherst, MA 01002-2933 | 2005-10-12 |
| 1033634977 | Jacqueline Wallace | Social Worker | 321 Blue Hill Ave, Dorchester, MA 02121-4302 | 2017-08-12 |
| 1518200740 | Jacqueline Wallace | Pharmacist | 1520 Main St, Windsor, CO 80550-7909 | 2013-04-06 |
| 1710920376 | Jacqueline Wallace | Registered Nurse | 530 N Main St, Providence, RI 02904-5762 | 2006-06-13 |
| Street Address |
10910 LITTLE PATUXENT PKWY SUITE 100 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044-3078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588832 | Kaiser Amir Ahmad | Internal Medicine | 10910 Little Patuxent Pkwy, Ste 100, Columbia, MD 21044-3078 | 2005-06-16 |
| 1720414493 | Howard County Center for Lung and Sleep Medicine | Psychologist | 10910 Little Patuxent Pkwy, Suite 100, Columbia, MD 21044-3081 | 2013-09-25 |
| 1154757326 | Howard County Center for Lung and Sleep Medicine LLC | Internal Medicine | 10910 Little Patuxent Pkwy, 100, Columbia, MD 21044-3078 | 2013-09-19 |
| 1124369038 | Suzanne Farhang Castner | Physician Assistant | 10910 Little Patuxent Pkwy, 200, Columbia, MD 21044-3078 | 2013-03-04 |
| 1699913731 | Sharon Silverman Md LLC | Internal Medicine | 10910 Little Patuxent Pkwy, Suite 105r, Columbia, MD 21044-3078 | 2009-01-28 |
| 1124204912 | Jacob Cherian Md LLC | Clinic/Center | 10910 Little Patuxent Pkwy, Suite 105r, Columbia, MD 21044-3078 | 2008-01-11 |
| 1194880898 | Melissa Ruth Reinhardt | Physical Therapist | 10910 Little Patuxent Pkwy, Suite 200, Columbia, MD 21044-3078 | 2006-12-25 |
| 1598850422 | Petra Dentistry LLC | Dentist | 10910 Little Patuxent Pkwy, Suite 206, Columbia, MD 21044-3078 | 2006-10-04 |
| 1780779660 | Lara E Philippi | Dentist | 10910 Little Patuxent Pkwy, Suite 206, Columbia, MD 21044-3078 | 2006-10-04 |
| 1205927613 | Jeff Scott Frattali | Physician Assistant | 10910 Little Patuxent Pkwy, Suite 205, Columbia, MD 21044-3078 | 2006-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 |
|---|---|---|---|---|
| 1750988036 | Lexington Health Inc | Obstetrics & Gynecology | 700 Gervais St Ste 300, Columbia, SC 29201-3061 | 2020-10-08 |
| 1700403334 | Sarah Mai Truong | Obstetrics & Gynecology | 402 N Keene St # Dc570.00, Columbia, MO 65201-6986 | 2020-06-30 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1962049593 | Michael Wayne Mccullough | Obstetrics & Gynecology | 500 N Keene St Ste 400, Columbia, MO 65201-8104 | 2019-12-02 |
| 1144881509 | Stephanie Barata | Obstetrics & Gynecology | 402 N Keene St Ste 402, Columbia, MO 65201-6986 | 2019-06-26 |
| 1407411895 | Silki Pankajkumar Modi | Obstetrics & Gynecology | The Women's Center, 1801 Sunseet Drive, Columbia, SC 29203 | 2019-05-01 |
| 1780105080 | Jennifer Irene Higdon | Obstetrics & Gynecology | Women's Center, 1801 Sunset Drive, Columbia, SC 29203 | 2017-06-28 |
| 1184157984 | Robert Mcdavid | Obstetrics & Gynecology | 3609 Arbor Ct, Columbia, MO 65201-6542 | 2017-04-07 |
| 1831548254 | Darrah Berck | Obstetrics & Gynecology | 1601 E Broadway Ste 300, Columbia, MO 65201-8022 | 2016-06-07 |
| 1285013276 | Whitney Lynn Shepard | Obstetrics & Gynecology | 1228 Harden St Ste B, Columbia, SC 29204-1800 | 2015-05-22 |
| Find all providers in COLUMBIA | ||||
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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.