MS. SUSAN H WALLACE (NPI# 1093826497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093826497 |
| Entity Type | Individual |
| Full Name | MS. SUSAN H WALLACE |
| Credential | APRN |
| Practice Address |
16120 W Dodge Rd Omaha NE 68118-2049 |
| Mailing Address |
Po Box 3755 Omaha NE 68103-0755 |
| Practice Telephone | 4023540550 |
| Practice Fax Number | 4023540555 |
| Mailing Telephone | 4023542100 |
| Mailing Fax Number | 4023541255 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 092180 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | 110115 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 47068731727 | 05 | |
| IA | 1093826497 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477910792 | Susan Anne Wallace | Licensed Practical Nurse | 44 Beechwood Dr, Manorville, NY 11949-2947 | 2016-01-16 |
| 1376842732 | Susan Elizabeth Wallace | Dietitian, Registered | 102 Carran Dr, Lakeside Park, KY 41017-2233 | 2011-03-23 |
| 1598904427 | Susan Leigh Wallace | Specialist | 103 Windwood Rd, North Syracuse, NY 13212-1956 | 2009-02-17 |
| 1366646457 | Susan Taylor Wallace | Speech-Language Pathologist | 3409 Connection Dr, Fayetteville, NC 28311-0151 | 2007-06-12 |
| 1952426025 | Susan Wallace | Acupuncturist | 1009 Solano Ave, # A, Albany, CA 94706-1617 | 2007-03-20 |
| 1447375662 | Susan D. Wallace | Counselor | 166 Pawtucket Avenue, Pawtucket, RI 02860-3811 | 2007-03-20 |
| 1639554769 | Susan Wallace | Physical Therapist | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2015-07-30 |
| 1740537687 | Susan R Wallace | Nurse Practitioner | 100 Methodist Blvd, Hattiesburg, MS 39402-1295 | 2012-08-09 |
| 1710247812 | Susan Victoria Wallace | Marriage & Family Therapist | 9685 Hayes St, Riverside, CA 92503-3660 | 2012-05-22 |
| 1427203462 | Susan Marie Wallace | Occupational Therapist | 355 Oak Grove Rd, Spartanburg, SC 29301-2537 | 2008-11-18 |
| Street Address |
16120 W DODGE RD |
| City | OMAHA |
| State | NE |
| Zip Code | 68118-2049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176506 | Michelle L Caffey | Physical Therapist | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2005-07-06 |
| 1760028153 | Md West One, PC | Neurological Surgery | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2019-11-21 |
| 1194226787 | Ryan M Houser | Physician Assistant | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2018-02-28 |
| 1982122917 | Madonna L Klein | Physical Therapist | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2017-08-30 |
| 1104368828 | Rachel L Anderson | Physical Therapist | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2016-11-11 |
| 1821440777 | Lauren Shoemaker | Internal Medicine | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2016-07-04 |
| 1093166050 | Michael Klug | Internal Medicine | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2016-06-30 |
| 1154775542 | Dianne Gillaspie | Physical Therapist | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2016-04-21 |
| 1871951327 | Mindy Keane | Physician Assistant | 16120 W Dodge Rd, Omaha, NE 68118-2049 | 2016-01-29 |
| 1700267978 | Rachelle Lou Naridze | Dermatology | 16120 W Dodge Rd, Omaha, NE 68118 | 2015-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932644127 | Renal Care Group of The Midwest, Inc. | Clinic/Center | 15801 West Dodge Road, Omaha, NE 68118 | 2016-12-27 |
| 1982091583 | Andrew Siref | Student in an Organized Health Care Education/Training Program | 16622 Howard Cir, Omaha, NE 68118 | 2015-04-21 |
| 1942628839 | Deirdre Anne Stolmeier | Dermatology | 515 N 162nd Ave Ste 302, Omaha, NE 68118 | 2014-03-28 |
| 1457625782 | James Clark | Pharmacist | 16130 Parker St, Omaha, NE 68118 | 2012-03-05 |
| 1619102613 | Children's West Village Pointe - Diagnostic Services | Spec/Tech, Pathology | 110 North 175 Street, Children's West Village Pointe - Diagnostic Services, Omaha, NE 68118 | 2009-05-19 |
| 1033359732 | Children's Hospital | Pediatrics | 110 North 175 Street, Suite 1000, Children's Hospital - Urgent Care - West Village Pointe, Omaha, NE 68118 | 2009-02-20 |
| 1285802538 | Becker Chiropractic LLC | Chiropractor | 17785 Mason St, Suite 101, Omaha, NE 68118 | 2008-02-20 |
| 1598940611 | Dane Patrick Becker | Chiropractor | 17785 Mason St., Suite 101, Omaha, NE 68118 | 2008-01-08 |
| 1700951779 | Karoline S Anderson | Pediatrics | 16811 Burke Street, Ste 101, Omaha, NE 68118 | 2006-11-22 |
| 1154435691 | Scott M Debates | Dermatology | 515 N 162nd Avennue, Ste. 302, Omaha, NE 68118 | 2006-08-19 |
| Find all providers in zip 68118 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466972 | Dana Mae Griffin | Nurse Practitioner | 3015 N 90th St Ste 1, Omaha, NE 68134-4713 | 2020-08-08 |
| 1740803022 | Marcia Marie Malone | Nurse Practitioner | 5045 S 153rd St, Omaha, NE 68137 | 2020-05-21 |
| 1275152084 | Natalie Roberts | Nurse Practitioner | 8701 F St, Omaha, NE 68127-1504 | 2020-04-11 |
| 1982233532 | Jill Renae Sheffield | Nurse Practitioner | 2910 N 63rd St, Omaha, NE 68104-3352 | 2020-04-06 |
| 1669000733 | Jessica D Flowers | Nurse Practitioner | 6901 N 72nd St Ste 7500, Omaha, NE 68122-1709 | 2020-04-01 |
| 1639716665 | Tiffany Tesoro | Nurse Practitioner | 16957 Locust St, Omaha, NE 68116-2658 | 2019-12-10 |
| 1366907529 | Jacqueline Mcduffie | Nurse Practitioner | 6774 Wirt St, Omaha, NE 68104-3143 | 2019-02-01 |
| 1366936023 | Debra Jo Warren | Nurse Practitioner | 4104 Leavenworth St, Omaha, NE 68105-1053 | 2018-06-18 |
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1336649987 | Colton A Palmer | Nurse Practitioner | 11725 Arbor St Ste 230, Omaha, NE 68144 | 2018-02-20 |
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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.