JAMIE RUSSELLE WALLACE (NPI# 1023066354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023066354 |
| Entity Type | Individual |
| Full Name | JAMIE RUSSELLE WALLACE |
| Credential | MD |
| Practice Address |
10752 N 89th Pl #126 Scottsdale AZ 85260 |
| Practice Telephone | 4808601161 |
| Practice Fax Number | 4808606561 |
| Mailing Telephone | (480) 860-1161 |
| Mailing Fax Number | 4808606561 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2017-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 12810 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 226143-001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881159242 | Jamie Lyn Wallace | Registered Nurse | 1648 Erin Hl, Stoughton, WI 53589-4853 | 2019-02-09 |
| 1689110918 | Jamie Renee' Wallace | Registered Nurse | 201 - Hospital Drive, Dover, OH 44622 | 2017-01-10 |
| 1144889486 | Jamie Marie Wallace | Physical Therapist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2019-06-11 |
| 1538654108 | Jamie Wallace | Technician | 1701 N Green Valley Pkwy Ste 9a, Henderson, NV 89074-5991 | 2018-06-26 |
| 1033659784 | Jamie Wallace | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2017-02-28 |
| 1649520511 | Jamie Wallace | Physical Therapist | 469 W Putnam Ave, Greenwich, CT 06830-6895 | 2012-09-18 |
| 1255523346 | Jamie Marie Wallace | Physician Assistant | 3311 Prescott Rd, Suite 201, Alexandria, LA 71301-3900 | 2007-08-13 |
| 1205883147 | Jamie F Wallace | Pediatrics | 735 Glynn St S, Fayetteville, GA 30214-2049 | 2006-05-27 |
| Street Address |
10752 N 89TH PL #126 |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144214354 | Lighthouse Center Inc. | Social Worker | 10752 N 89th Pl, Suite 113, Scottsdale, AZ 85260-6730 | 2005-09-02 |
| 1407395825 | Ace Peridontics PC | Dentist | 10752 N 89th Pl, Suite 214, Scottsdale, AZ 85260-6730 | 2017-02-17 |
| 1437697612 | Foley-pierce, LLC | Home Health | 10752 N 89th Pl, Suite 106a, Scottsdale, AZ 85260-6730 | 2017-02-07 |
| 1437604261 | Alexandra R Schilling | Psychologist | 10752 N 89th Pl, 227c, Scottsdale, AZ 85260-6730 | 2016-08-22 |
| 1629436076 | Pierce-foley, LLC | Home Health | 10752 N 89th Pl, Suite 106a, Scottsdale, AZ 85260-6730 | 2016-01-31 |
| 1740665223 | New Life Women's Health Pllc | Nurse Practitioner | 10752 N 89th Pl, Suite 220b, Scottsdale, AZ 85260-6730 | 2015-07-24 |
| 1588076889 | Traci Solano | Massage Therapist | 10752 N 89th Pl, Scottsdale, AZ 85260-6730 | 2014-05-21 |
| 1962839662 | Patrick Davis | Massage Therapist | 10752 N 89th Pl, Suite B-122, Scottsdale, AZ 85260-6730 | 2013-09-26 |
| 1376827402 | 360 Physical Therapy LLC | Specialist | 10752 N 89th Pl, Ste C 134, Scottsdale, AZ 85260-6730 | 2011-10-07 |
| 1184954273 | Cbbl Entreprises LLC | Home Health | 10752 N 89th Pl, Suite 232, Scottsdale, AZ 85260-6730 | 2010-01-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153377 | Karen Lee Williams | Counselor | 7655 Eest Redfield Rd, Suite 4, Scottsdale, AZ 85260 | 2020-10-29 |
| 1477188001 | Dr. Lynne Remson, Stuttering Specialist, LLC | Clinic/Center | 7950 E. Acoma Dr., Ste 201, Scottsdale, AZ 85260 | 2020-03-04 |
| 1861049967 | Aca Wellness Institute | Registered Nurse | 10752 N. 89th Pl, 8, Ste 203, Scottsdale, AZ 85260 | 2019-08-22 |
| 1811542814 | Haven Home Physicians LLC | Internal Medicine | 15551 N Greenway-hayden Loop, Suite 155, Scottsdale, AZ 85260 | 2019-08-06 |
| 1700431079 | Corey Allen Niles | Physical Therapist | 16413 N 91st Street #c145, Scottsdale, AZ 85260 | 2019-08-05 |
| 1578126470 | Scottsdale Pediatric Dental Associates Inc | Dentist | 9280 E Raintree, Suite 108, Scottsdale, AZ 85260 | 2019-04-16 |
| 1548747645 | Oliver Canizales Renteria | Behavior Technician | 8310 East Cactus Road, Suite # 510, Scottsdale, AZ 85260 | 2018-07-23 |
| 1518454792 | Silent Night Sleep Center Lllp | Durable Medical Equipment & Medical Supplies | 9070 E Desert Cove Ave Ste 105, Scottsdale, AZ 85260 | 2018-04-13 |
| 1669976726 | Steincare Mobile Outpatient, LLC | Occupational Therapist | 9555 E. Raintree Drive, #2057, Scottsdale, AZ 85260 | 2018-03-22 |
| 1437658416 | Megan Anne Deffenbaugh | Behavior Technician | 8130 E Cactus Rd Suite 150, Scottsdale, AZ 85260 | 2018-02-06 |
| Find all providers in zip 85260 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306487350 | Roots Pediatric Therapy, LLC | Pediatrics | 7340 E Legacy Blvd Unit C2006, Scottsdale, AZ 85255-6388 | 2019-10-01 |
| 1164985305 | Desert Sky Pediatrics | Pediatrics | 3301 N Miller Rd Ste 170, Scottsdale, AZ 85251-6421 | 2019-04-12 |
| 1770093221 | Brittany Wilson | Pediatrics | 8573 E San Alberto Dr Ste E100, Scottsdale, AZ 85258-4612 | 2017-10-10 |
| 1154854537 | Alexandra Kauffman | Pediatrics | 5425 E Bell Rd Ste 145, Scottsdale, AZ 85254-6010 | 2017-04-04 |
| 1174919997 | Kelsey Elizabeth Chemelewski | Pediatrics | 8573 E San Alberto Ste E100, Scottsdale, AZ 85258-4612 | 2015-04-08 |
| 1144526450 | Kamla Kumar | Pediatrics | 12148 N. 134th Way, Scottsdale, AZ 85259 | 2011-02-03 |
| 1760708168 | Colin George Petranu | Pediatrics | 9827 N 95th St Ste 105, Scottsdale, AZ 85258-4591 | 2010-04-12 |
| 1093047011 | Philip Albert Bond | Pediatrics | 11825 E Desert Trail Rd, Scottsdale, AZ 85259-2726 | 2010-02-01 |
| 1053556241 | Michelle Ellen Buenafe | Pediatrics | 5046 E Corrine Dr, Scottsdale, AZ 85254-4143 | 2008-12-03 |
| 1861665671 | David Allen Scheer | Pediatrics | 5461 E Cortez Dr, Scottsdale, AZ 85254-4733 | 2008-04-12 |
| Find all providers in SCOTTSDALE | ||||
| City | SCOTTSDALE |
| Zip Code | 85260 |
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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.