BRIANNA WALLACE (NPI# 1194336271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194336271 |
| Entity Type | Individual |
| Full Name | BRIANNA WALLACE |
| Practice Address |
1 Wellness Way Pueblo CO 81006-2103 |
| Mailing Address |
41 Montebello Rd Ste 204 Pueblo CO 81001-1379 |
| Practice Telephone | 7195452746 |
| Mailing Telephone | 7195452746 |
| Mailing Fax Number | 7195454100 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560535 | Brianna Wallace | Technician | 1811 S Jones Blvd, Las Vegas, NV 89146-1259 | 2020-05-21 |
| 1164085411 | Brianna Kyle Wallace | Chiropractor | 690 Riverside Ave, Adrian, MI 49221-1544 | 2019-04-22 |
| Street Address |
1 WELLNESS WAY |
| City | PUEBLO |
| State | CO |
| Zip Code | 81006-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505223 | Joseph Lucero | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-10-09 |
| 1083220081 | Jordan Waller | Counselor | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-09-16 |
| 1689285710 | Lori Pizarro | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-08-12 |
| 1609496322 | Danette Ballard | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-04-22 |
| 1356750145 | Kolbie Gardner | Registered Nurse | 1 Wellness Way, Pueblo, CO 81006-2103 | 2014-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181760 | Kaitlyn Pullara | Registered Nurse | 1 El Pueblo Way, Pueblo, CO 81006 | 2020-10-13 |
| 1528593167 | Melissa Dasher | Dental Hygienist | 1292 Zinno Blvd, Pueblo, CO 81006 | 2017-04-20 |
| 1043588833 | Johnathan Seamus Waters | Radiologic Technologist | 2223 Daniel Road, Pueblo, CO 81006 | 2011-12-07 |
| 1992858344 | El Pueblo Boys' and Girls' Ranch, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1 El Pueblo Ranch Way, Pueblo, CO 81006 | 2007-01-19 |
| 1740347996 | Jose Luis Ramirez | Physician Assistant | 45825 Highway 96 East, Pueblo, CO 81006 | 2007-01-03 |
| 1730514019 | Tammy Kay Salmon | Social Worker | 1 El Pueblo Ranch Way, Pueblo, CO 81006 | 2013-09-05 |
| 1518062074 | American Medical Response of Colorado Inc | Ambulance | 922 S Santa Fe Ave, Pueblo, CO 81006-1125 | 2006-09-13 |
| 1255654935 | B-4 Day Program and Residential Services Inc. | Day Training, Developmentally Disabled Services | 110 Santa Fe Dr, Pueblo, CO 81006-1174 | 2010-03-09 |
| 1467083022 | Stephanie Ortega | Counselor | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-01-31 |
| 1053918623 | Health Solutions | Clinic/Center | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-10-06 |
| Find all providers in zip 81006 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295380319 | Andrea Vigil | Case Manager/Care Coordinator | 41 Montebello Rd Ste 100, Pueblo, CO 81001-1366 | 2019-08-06 |
| 1215300744 | Mary Sianez | Case Manager/Care Coordinator | 1612 Bonforte Blvd, Pueblo, CO 81001-1603 | 2015-11-05 |
| 1912505223 | Joseph Lucero | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-10-09 |
| 1619575966 | Samantha Luken | Case Manager/Care Coordinator | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-09 |
| 1851907802 | Alexis Cordova | Case Manager/Care Coordinator | 1012 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-09-16 |
| 1689285710 | Lori Pizarro | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-08-12 |
| 1811505985 | Lindsay Carleton | Case Manager/Care Coordinator | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-15 |
| 1265050306 | Rick Ramos | Case Manager/Care Coordinator | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-06 |
| 1609496322 | Danette Ballard | Case Manager/Care Coordinator | 1 Wellness Way, Pueblo, CO 81006-2103 | 2020-04-22 |
| 1982239067 | Jordan Drake | Case Manager/Care Coordinator | 1310 Chinook Ln, Pueblo, CO 81001-1851 | 2020-03-09 |
| Find all providers in PUEBLO | ||||
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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.