DR. JESSICA WALLACE (NPI# 1235658626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235658626 |
| Entity Type | Individual |
| Full Name | DR. JESSICA WALLACE |
| Credential | PHD, AT, ATC |
| Practice Address |
1 University Plz Youngstown OH 44555-0001 |
| Practice Telephone | (330) 941-2577 |
| Mailing Telephone | 3309412577 |
| Enumeration Date | 2017-09-17 |
| Last Update Date | 2017-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT004914 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871089680 | Jessica Renee Wallace | Nurse Practitioner | 1821 E. High St., Springfield, OH 45505 | 2018-07-04 |
| 1821517210 | Jessica Wallace | Behavioral Analyst | 43835 Timber Sq Unit 203, Leesburg, VA 20176-3432 | 2017-09-17 |
| 1548639560 | Jessica Ann Wallace | Physician Assistant | 1890 Us Highway 131 Unit 4, Petoskey, MI 49770-8344 | 2015-09-21 |
| 1285031682 | Jessica Wallace | Speech-Language Pathologist | 2900 Knox School Rd, Alliance, OH 44601-9021 | 2014-12-01 |
| 1073940888 | Jessica Wallace | Marriage & Family Therapist | 15611 Pomerado Rd Ste 535, Poway, CA 92064-2437 | 2013-10-11 |
| 1245577907 | Jessica Wallace | Pharmacist | 6175 Hickory Flat Hwy, Suite 140, Canton, GA 30115-7207 | 2013-01-14 |
| 1659637478 | Jessica Lynn Wallace | Community/Behavioral Health | 26652 Muse Road, Muse, OK 74949 | 2012-04-05 |
| 1669751418 | Jessica Leigh Wallace | Physical Therapist | 224 Old River Rd, Bluffton, SC 29909-3952 | 2011-08-11 |
| 1689846164 | Jessica Nicole Wallace | Registered Nurse | 655 Front St, Middleport, OH 45760 | 2008-03-25 |
| 1710507371 | Jessica M Wallace | Nurse Anesthetist, Certified Registered | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-04-23 |
| Street Address |
1 UNIVERSITY PLZ |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44555-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736341 | Sara Amalia Moore | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-3652 | 2020-09-30 |
| 1093354136 | Nathaniel Robert Hinderer | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0002 | 2020-01-06 |
| 1386291128 | Alena Anastasia Burzynski | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2019-08-26 |
| 1932756772 | Austin James Munno | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2019-08-26 |
| 1770048761 | Raymond David Peters | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2019-02-05 |
| 1598220584 | Christopher Brad Wilkins | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0002 | 2019-02-05 |
| 1356812119 | Erin Marie Pavick | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2018-12-05 |
| 1194296947 | Kyle Robert Hegedus | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2018-12-05 |
| 1194295147 | Stephanie Marie Demain | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2018-12-03 |
| 1750851960 | Derek Bodo | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-0001 | 2018-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902046725 | The Rich Center for Autism @ysu | Behavioral Analyst | One University Plaza, Youngstown, OH 44555 | 2009-03-06 |
| 1750852513 | Alek Trenton Monger | Specialist/Technologist | 1 University Plaza, Youngstown, OH 44555 | 2018-12-05 |
| 1093323057 | Adam Feinberg | Neuromusculoskeletal Medicine, Sports Medicine | 1 University Plz Dept Of, Youngstown, OH 44555-0001 | 2020-07-16 |
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484189 | Kyle Dalton Flora | Specialist/Technologist | 577 5th Ave Rm 1103, Youngstown, OH 44502 | 2020-07-09 |
| 1407313190 | Mark Dell | Specialist/Technologist | 474 Bennington Ave, Youngstown, OH 44505-3508 | 2019-02-28 |
| 1326505561 | Luke Olesky | Specialist/Technologist | 3481 Black Oak Ln, Youngstown, OH 44511-2643 | 2019-02-25 |
| 1952866733 | Kara Louise Trella | Specialist/Technologist | 1650 Weston Ave, Youngstown, OH 44514-1040 | 2019-02-05 |
| 1902376742 | Shamara Golden | Specialist/Technologist | 3415 5th Ave, Youngstown, OH 44505 | 2018-12-04 |
| 1588155162 | Luke Cantin | Specialist/Technologist | 577 5th Ave, Youngstown, OH 44502 | 2018-05-19 |
| 1215383765 | Kacie Donahue | Specialist/Technologist | 4606 Walnut Trce, Youngstown, OH 44515-1230 | 2016-05-13 |
| 1023498300 | Steve Hunter Seifert IIi | Specialist/Technologist | 230 Erskine Ave, Youngstown, OH 44512-2337 | 2015-06-02 |
| 1477988582 | Anthony James Pozzuto | Specialist/Technologist | 2545 Erie St, Youngstown, OH 44507-1522 | 2013-09-08 |
| 1134736341 | Sara Amalia Moore | Specialist/Technologist | 1 University Plz, Youngstown, OH 44555-3652 | 2020-09-30 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44555 |
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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.