Kimberly A Wallace (NPI# 1457697435, PAC ID# 2769637628) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1457697435 |
| PAC ID by PECOS | 2769637628 |
| Professional Enrollment ID | I20130225000462 |
| Full Name | Kimberly A Wallace |
| Organization Legal Name | WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION |
| Address |
11 N Locust St Uha Buckhannon Buckhannon WV 26201-2231 |
| Phone Number | 3044721600 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1052224565 |
| Number of Group Practice Members | 1143 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 510001 | WEST VIRGINIA UNIVERSITY HOSPITALS |
| 510038 | STONEWALL JACKSON MEMORIAL HOSPITAL |
| 510006 | UNITED HOSPITAL CENTER |
| 511321 | ST JOSEPH'S HOSPITAL |
| 510047 | FAIRMONT REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 11 N Locust St, Uha Buckhannon, Buckhannon, WV 26201-2231 | 3044721600 | WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION |
| Organization Legal Name | WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION |
| Physicians | 1207 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Molly Ober Fechter-leggett | Psychologist, Clinical | West Virginia University Medical Corporation | 3602 Collins Ferry Rd, Morgantown, WV 26505-2378 |
| Matraca Hovatter | Nurse Practitioner | West Virginia University Medical Corporation | 250 Retail Cir, Suite 106, Morgantown, WV 26508-1647 |
| Farheen Shirazi | Cardiovascular Disease (cardiology) | West Virginia University Medical Corporation | 13079 Garrett Hwy, Uha Oakland Ckd Clinic, Oakland, MD 21550 |
| Mackenzie James Clarkson | Internal Medicine | West Virginia University Medical Corporation | 14 Comfort Dr, Reedsville, WV 26547-0359 |
| Kristin Wendell | Nurse Practitioner | West Virginia University Medical Corporation | 205 Bakers Ridge Rd, Morgantown, WV 26508-1500 |
| Emily Butler | Physician Assistant | West Virginia University Medical Corporation | 3803 Emerson Ave, Parkersburg, WV 26104-1116 |
| Irfan Zeb | Internal Medicine | West Virginia University Medical Corporation | 426 8th St, Glen Dale, WV 26038-1451 |
| Binu T Chacko | Internal Medicine | West Virginia University Medical Corporation | 2601 Cranberry Sq, Morgantown, WV 26508-9201 |
| Jada Lauren Powell | Nurse Practitioner | West Virginia University Medical Corporation | 30 Mon General Dr, Morgantown, WV 26505-2853 |
| Omar Duenas | Obstetrics/gynecology | West Virginia University Medical Corporation | 1160 Van Voorhis Rd, Morgantown, WV 26505-3435 |
| Street Address |
11 N LOCUST ST UHA BUCKHANNON |
| City | BUCKHANNON |
| State | WV |
| Zip | 26201-2231 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Leann Carr | Nurse Practitioner | West Virginia Gastroenterology and Endoscopy | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Michelle Lynn Ratnakar | Physician Assistant | West Virginia Gastroenterology and Endoscopy | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Harold D Zorger | Podiatry | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Catherine M Chua | Family Medicine | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Kessa Dawn Thorpe | Physician Assistant | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Steven R Toney | Family Medicine | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Deborah L Chadwick | General Surgery | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Garrett L Butler | Family Medicine | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| James W Gainer | Family Medicine | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Theresa Ann Poling I | Nurse Practitioner | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Salam Rajjoub | Pulmonary Disease | 2 Amalia Dr, Buckhannon, WV 26201-2223 | |
| Ali A Khan | Internal Medicine | Associated Specialists, Inc | 2 Hartman Plz, Buckhannon, WV 26201-2230 |
| Walter C Boardwine | Orthopedic Surgery | Davis Memorial Hospital | 11 N Locust St, Buckhannon, WV 26201-2231 |
| Joshua Steven Baker | Physician Assistant | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Amber R Blackledge | Physician Assistant | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Angela Sue Mahaffey | Nurse Practitioner | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Angela Megan Sessions | Nurse Practitioner | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Melissa Shockey Dodrill | Family Medicine | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Yvonne Marie Staschiak | Nurse Practitioner | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Nathaniel Shay Linger | Family Medicine | Community Care of West Virginia, Inc. | 33 37 W Main St, Buckhannon, WV 26201-2235 |
| Find all physicians in zip 26201 | |||
| City | BUCKHANNON |
| Zip Code | 26201 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BUCKHANNON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kimberly A Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.