DEBORAH I WALLACE (NPI# 1184654709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184654709 |
| Entity Type | Individual |
| Full Name | DEBORAH I WALLACE |
| Credential | M.D. |
| Practice Address |
3840 Ruckriegel Pkwy Suite 105 Louisville KY 40299-6835 |
| Practice Telephone | 5022617227 |
| Practice Fax Number | 8449659615 |
| Mailing Telephone | 5022617227 |
| Mailing Fax Number | 8449659615 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39992 | KY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548665037 | Deborah Wallace | Contractor | 1115 13th St Se, Canton, OH 44707-3425 | 2014-10-27 |
| 1821333113 | Deborah Elaine Wallace | Physical Therapy Assistant | 5147 Spring St, Sylvania, OH 43560-2832 | 2012-11-28 |
| 1124195359 | Deborah S Wallace | Dentist | 445 Highway 79, Dover, TN 37058-6941 | 2006-11-30 |
| 1194251173 | Deborah Wallace | Counselor | 801 Empire St, Fairfield, CA 94533 | 2017-05-11 |
| 1215387832 | Deborah Wallace | Nurse Practitioner | 4 Ryan Rd, Marlboro, NJ 07746-2445 | 2016-06-14 |
| 1235526633 | Deborah Wallace | Licensed Practical Nurse | 6040 Southport Dr, Bethesda, MD 20814-1848 | 2015-04-23 |
| 1083859730 | Deborah Elaine Wallace | Nurse Practitioner | 3601 Tvc, Nashville, TN 37232-0001 | 2008-12-10 |
| 1295950244 | Deborah A. Wallace | Occupational Therapist | 710 S Paulina St, Chicago, IL 60612-3808 | 2007-04-16 |
| 1184667388 | Deborah A Wallace | Nurse Anesthetist, Certified Registered | 1000 Medical Center Blvd, Lawrenceville, GA 30046-0000 | 2006-06-14 |
| Street Address |
3840 RUCKRIEGEL PKWY SUITE 105 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40299-6835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720086804 | Joseph Charles Pappalardo | Pediatrics | 3840 Ruckriegel Pkwy, Ste. 105, Louisville, KY 40299-6835 | 2005-07-12 |
| 1225327174 | Sara Greene Diebold | Pediatrics | 3840 Ruckriegel Pkwy, Suite 105, Louisville, KY 40299-6835 | 2011-03-31 |
| 1689672776 | Mary Elizabeth Knights | Pediatrics | 3840 Ruckriegel Pkwy, Ste. 105, Louisville, KY 40299-6835 | 2005-07-12 |
| 1629076716 | Pediatric Partners of Jeffersontown | Pediatrics | 3840 Ruckriegel Pkwy, Ste105, Louisville, KY 40299-3986 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477050144 | Jolanta Staniszewska | Social Worker | 1700 Cargo St, Louisville, KY 40299 | 2018-04-10 |
| 1780192302 | Chris Mcclain | Pharmacist | 1901 Campus Place, Suite 100, Louisville, KY 40299 | 2018-01-17 |
| 1669984209 | Bluegrass Allergy Asthma and Immunology Psc | Internal Medicine | 11900 Plantside Dr Ste 9, Louisville, KY 40299 | 2017-11-03 |
| 1588182109 | Hollie Marie Wheeler | Speech-Language Pathologist | Paragon Rehabilitation 2701 Chesnut Station Court, Louisville, KY 40299 | 2017-09-04 |
| 1790206464 | Farrah Hill Rodgers | Occupational Therapy Assistant | 2701 Chestnut Station Court., Paragon Rehabilitation, Louisville, KY 40299 | 2017-07-03 |
| 1871972620 | Jag Medical LLC | Pharmacy | 9813 Merioneth Dr, Louisville, KY 40299 | 2015-05-27 |
| 1023496205 | Scotty Ray Newcomer | Family Medicine | 8511 Watterson Trl, Louisville, KY 40299 | 2015-05-08 |
| 1386048262 | Daniel Gerhard Eschenbach | Dentist | 12613 Taylorsville Rd., Suite #17, Louisville, KY 40299 | 2014-10-21 |
| 1740616192 | Alyse C Martin | Nurse Practitioner | 9569 Taylorsville Road Suite 109, Louisville, KY 40299 | 2013-09-17 |
| 1407104128 | Tammy Rowland Reddington | Nurse Practitioner | 4004 Hurstbroune Woods Drive, Louisville, KY 40299 | 2012-08-28 |
| Find all providers in zip 40299 | ||||
| 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 |
|---|---|---|---|---|
| 1306316989 | Jacquee L Mcnear | Pediatrics | 801 Barret Avenue Suite 314, Louisville, KY 40204-1701 | 2018-11-27 |
| 1902292857 | Hayley Redmond | Pediatrics | 571 S Floyd St Ste 332, Louisville, KY 40202 | 2015-04-07 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1114332236 | Amanda Brian Rogers | Pediatrics | 411 E Chestnut St # Street6, Louisville, KY 40202-1713 | 2014-06-26 |
| 1770900144 | Kathryn Thorne | Pediatrics | 9710 Park Plaza Ave Unit 107, Louisville, KY 40241-2292 | 2014-03-24 |
| 1669717690 | Surjeet Singh Dhanjal | Pediatrics | 1506 Thackeray Dr, Louisville, KY 40205-2410 | 2012-12-03 |
| 1164656443 | Betty Sue Spivack | Pediatrics | 8804 Nottingham Pkwy, Louisville, KY 40222-5217 | 2009-05-14 |
| 1821238528 | James Grant Mumford | Pediatrics | 5100 Commerce Crossings Dr, Louisville, KY 40229-2128 | 2009-02-20 |
| 1033371216 | Jonathan R Malowitz | Pediatrics | 4123 Dutchmans Lane Suite 301, Suburban Medical Plaza 3, Louisville, KY 40207 | 2008-06-27 |
| 1356509954 | Julia Lane Mitchell | Pediatrics | 760 S. Hancock St, B100, Louisville, KY 40203 | 2008-05-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40299 |
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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.