COLLEEN MICHELLE WALLACE (NPI# 1255627469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255627469 |
Entity Type | Individual |
Full Name | COLLEEN MICHELLE WALLACE |
Credential | M.D. |
Practice Address |
3300 Gallows Rd Falls Church VA 22042-3307 |
Mailing Address |
3220 12th St Ne Washington DC 20017-4032 |
Practice Telephone | 7037767834 |
Mailing Telephone | 5042848837 |
Enumeration Date | 2011-06-26 |
Last Update Date | 2018-06-25 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208000000X | Pediatrics | 0116023955 | VA | Allopathic & Osteopathic Physicians |
Y | 208000000X | Pediatrics | D78050 | MD | Allopathic & Osteopathic Physicians |
N | 208M00000X | Hospitalist | D78050 | MD | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992043210 | Colleen Therese Wallace | Skilled Nursing Facility | 9286 Arpin Richfield Rd, Arpin, WI 54410-9514 | 2013-01-21 |
1457964678 | Colleen R Wallace | Physical Therapist | 143 Raymond Rd, Candia, NH 03034-2133 | 2020-08-27 |
1720289580 | Colleen Carver Wallace | Social Worker | 1150 Scioto St, Urbana, OH 43078-2289 | 2007-05-30 |
1194743815 | Colleen Maire Wallace | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-18 |
Street Address |
3300 GALLOWS RD |
City | FALLS CHURCH |
State | VA |
Zip Code | 22042-3307 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639177942 | Bestpractices, Inc. | Emergency Medicine | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2005-07-11 |
1659971216 | Mahsa Roohani | Nurse Practitioner | 3300 Gallows Rd, Falls Church, VA 22042-3300 | 2020-10-31 |
1861092330 | Jessica Merberg | Genetic Counselor, MS | 3300 Gallows Rd, Falls Church, VA 22042-3300 | 2020-10-26 |
1366042780 | Kirsten Smith | Nurse Practitioner | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-10-26 |
1629677026 | Laurie Brutus | Registered Nurse | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-10-19 |
1184223539 | Mirnesa Tikvina | Registered Nurse | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-10-17 |
1073111779 | Kirsten Kadlec | Nurse Anesthetist, Certified Registered | 3300 Gallows Rd, Falls Church, VA 22042-3300 | 2020-10-14 |
1114525953 | Jennifer Yung | Registered Nurse | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-10-14 |
1720685522 | Laura Musser | Registered Nurse | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-10-05 |
1154938926 | Heather Elizabeth Carvalho | Nurse Practitioner | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2020-09-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982220190 | Alicia Derusso St. Thomas | Student in an Organized Health Care Education/Training Program | Obgyn Admin Suite 2nd Floor South Tower, 3300 Gallows Rd, Falls Church, VA 22042 | 2020-06-23 |
1316574320 | Marina A Kalugina | Radiologic Technologist | 3330 Gallows Rd, Falls Church, VA 22042 | 2020-03-27 |
1992347645 | Home Injections Plus LLC | Registered Nurse | 7598 Lakeside Village Dr, Unit E, Falls Church, VA 22042 | 2019-10-15 |
1205493129 | Meredith Hooover | Obstetrics & Gynecology | 3300 Gallows Rd Falls Church, Va 22042 - 3307, Arlington, VA 22042 | 2019-05-27 |
1699269076 | Ibrahim Tora | Student in an Organized Health Care Education/Training Program | Department of Medicine, Npt-2, 3300 Gallows Rd, Falls Church, VA 22042 | 2018-06-19 |
1528559960 | Robert Patton | Student in an Organized Health Care Education/Training Program | Inova Fairfax Medical Campus, 3300 Gallows Road, Department of Medicine, Npt-2, Falls Church, VA 22042 | 2018-05-22 |
1144726951 | Helene M Sterbling | Student in an Organized Health Care Education/Training Program | Inova Fairfax Medical Campus, 3300 Gallows Road, Falls Church, VA 22042 | 2018-04-02 |
1659876530 | Cassandra Lyn Presti | Obstetrics & Gynecology | 3300 Gallows Rd Fl 2, Falls Church, VA 22042 | 2018-03-24 |
1225530157 | Sara Sigler | Audiologist | 3036 Graham Rd - Main Office Suite, Graham Road Community Building, Falls Church, VA 22042 | 2018-03-07 |
1003314949 | Ameriwell Clinics Falls Church, LLC | Chiropractor | 6521 Arlington Blvd Suite 402, Falls Church, VA 22042 | 2018-01-25 |
Find all providers in zip 22042 |
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 |
---|---|---|---|---|
1447678420 | Tiffany Mangal | Pediatrics | 6565 Arlington Blvd Ste 210, Falls Church, VA 22042-3000 | 2014-04-07 |
1811230196 | Katherine Baeder | Pediatrics | 407 N Washington St Ste 100, Falls Church, VA 22046 | 2013-04-04 |
1043477722 | Jessica Marie Mumme | Pediatrics | 6400 Arlington Blvd Ste 200, Falls Church, VA 22042-2336 | 2008-05-20 |
1780888776 | Northern Virginia Pediatrics PC | Pediatrics | 107 No Virginia Avenue, Falls Church, VA 22046 | 2007-06-13 |
1710045976 | Lisa Stehli Kelly | Pediatrics | 107 North Virginia Avenue, Falls Church, VA 22046 | 2006-12-04 |
1184714057 | Diane Linda Halpin | Pediatrics | 107 N Virgina Ave, Falls Church, VA 22046 | 2006-10-13 |
1407945835 | Sein Win | Pediatrics | 6408 Seven Corners Pl Ste A, Falls Church, VA 22044-2011 | 2006-10-12 |
1174627129 | Christina Fuentes Frayna | Pediatrics | 6231 Leesburg Pike Ste 203, Falls Church, VA 22044-2102 | 2006-09-11 |
1700996881 | Tung Duc Nguyen | Pediatrics | 6404-k Seven Corners Place, Falls Church, VA 22044 | 2006-08-30 |
1023128014 | Tru Van Le | Pediatrics | 6404 Seven Corners Pl Ste F, Falls Church, VA 22044-2033 | 2006-08-30 |
Find all providers in FALLS CHURCH |
City | FALLS CHURCH |
Zip Code | 22042 |
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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.