Amy D Wallen (NPI# 1831581222, PAC ID# 9436307139) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1831581222 |
| PAC ID by PECOS | 9436307139 |
| Professional Enrollment ID | I20150520000874 |
| Full Name | Amy D Wallen |
| Organization Legal Name | QSR PSYCHIATRIC SOLUTIONS LLC |
| Address |
12855 N 40 Dr Suite 385 Saint Louis MO 63141-8665 |
| Phone Number | 3142218177 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7911230248 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 261308 | WASHINGTON COUNTY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 402 S Silver Springs Rd, Cape Girardeau, MO 63703-7536 | 5733341100 | COMMUNITY COUNSELING CENTER |
| 12855 N 40 Dr, Suite 385, Saint Louis, MO 63141-8665 | 3142218177 | QSR PSYCHIATRIC SOLUTIONS LLC |
| Organization Legal Name | QSR PSYCHIATRIC SOLUTIONS LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Quentin Chambers | Nurse Practitioner | Qsr Psychiatric Solutions LLC | 12855 N 40 Dr, Suite 385, Saint Louis, MO 63141-8665 |
| Street Address |
12855 N 40 DR SUITE 385 |
| City | SAINT LOUIS |
| State | MO |
| Zip | 63141-8665 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel Porter | Nurse Practitioner | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Danielle N Fries | Nurse Practitioner | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Jaeyoung Yoon | Dermatology | Forefront Dermatology Sc | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 |
| Sarah Alison Finger Basak | Dermatology | Forefront Dermatology Sc | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141-8657 |
| Karuna P Murray | Gynecological Oncology | 12855 N 40 Dr, Suite 325, Saint Louis, MO 63141-8668 | |
| Seth Strope | Urology | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Steven R Frank | Podiatry | Steven Frank, Dpm, LLC | 12855 N 40 Dr, Suite 175, Saint Louis, MO 63141-8664 |
| Demetrios A Katsikas | Urology | Urology of St. Louis, Inc | 12855 N 40 Dr, Suite 375, Saint Louis, MO 63141-8657 |
| Ryan W Couchman | Orthopedic Surgery | Mercy Clinic Surgical Specialists LLC | 12855 N 40 Dr, Suite 125, Saint Louis, MO 63141-8663 |
| Byron D Baptist | Internal Medicine | Mercy Clinic East Communities | 12855 N 40 Dr, 280 Mercy Clinic Diabetes and Nutrition Center, Saint Louis, MO 63141-8657 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Finnerty | Nurse Practitioner | Associated Physicians Group Ltd | 845 N New Ballas Court, Suite 120, Creve Couer, MO 63141 |
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Matthew Stewart Wilson | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Patricia L Tracy | Physical Therapy | Associated Physicians Group, Ltd | 845 N New Ballas Court, Creve Couer, MO 63141 |
| Kevin O Easley | Gynecological Oncology | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Kelly L Ball | Nurse Practitioner | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Amy Kelly Neu | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Find all physicians in zip 63141 | |||
| City | SAINT LOUIS |
| Zip Code | 63141 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SAINT LOUIS + NURSE PRACTITIONER |
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| 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.