COURTNEY BROOKE WALLACE (NPI# 1285877217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285877217 |
| Entity Type | Individual |
| Full Name | COURTNEY BROOKE WALLACE |
| Credential | PT |
| Practice Address |
5409 Harrington Grove Dr Raleigh NC 27613-5701 |
| Practice Telephone | 9196010149 |
| Practice Fax Number | 9198471649 |
| Mailing Telephone | 9198471601 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2013-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | 8974 | NC | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285102533 | Courtney Lynn Wallace | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2018-11-05 |
| 1508396789 | Courtney Nicole Wallace | Audiologist | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2017-06-19 |
| 1548692189 | Courtney Creal Wallace | Counselor | 1432 S Shelby St, Louisville, KY 40217-1166 | 2013-08-06 |
| Street Address |
5409 HARRINGTON GROVE DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27613-5701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588124358 | Arend Klooster Dds II, Pllc | Dentist | 3721 Lynn Rd. #120, Raleigh, NC 27613 | 2019-03-20 |
| 1205319647 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 9640 Leesville Rd, Raleigh, NC 27613 | 2018-09-12 |
| 1386137735 | Maitlyn Avery Betts | Specialist/Technologist | 8421 Two Courts Drive, Raleigh, NC 27613 | 2018-06-11 |
| 1811492382 | Malek & Knight Dds Pa-iil | Dentist | 9201 Leesville Rd Ste 101, Raleigh, NC 27613 | 2018-03-27 |
| 1285151860 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 13300 Stickland Rd, Raleigh, NC 27613 | 2017-08-24 |
| 1376072165 | Caitlin Ann Singleton | Dentist | 13220 Strickland Rd Ste 166, Raleigh, NC 27613 | 2017-06-06 |
| 1508246547 | Jonathan Kent Weisner | Dentist | 13271 Strickland Rd, Raleigh, NC 27613 | 2015-06-04 |
| 1245620806 | Kimberly Szwed | Nurse Practitioner | 6422 Rosny Road, Raleigh, NC 27613 | 2015-02-03 |
| 1174957831 | Laurin Ballowe Collier | Pharmacist | 9640 Leesville Road, Raleigh, NC 27613 | 2013-08-29 |
| 1952655144 | Phillip Colby Smith | Marriage & Family Therapist | 6921 Springcreek Cv Apt 22, Raleigh, NC 27613 | 2012-11-09 |
| Find all providers in zip 27613 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205454501 | Kristal Leigh Armstrong | Contractor | 460 Dickens Dr, Raleigh, NC 27610-2454 | 2020-07-13 |
| 1538685847 | Candice Branch-jacobs | Contractor | 836 Crown Crossing Ln, Raleigh, NC 27610-4063 | 2017-08-17 |
| 1841729001 | Reliance Medical Management, LLC | Contractor | 4242 Six Forks Rd Ste 1550, Raleigh, NC 27609-6084 | 2017-06-09 |
| 1063957736 | Jp Phinney | Contractor | 5102 Oak Park Rd, Ste B, Raleigh, NC 27612-3027 | 2017-01-04 |
| 1366985194 | Kavita Joshi | Contractor | 3001 Spring Forest Road, Raleigh, NC 27616 | 2016-11-28 |
| 1437524329 | Clifford Thomas | Contractor | 7016 Beaverwood Dr, Raleigh, NC 27616-6496 | 2015-12-03 |
| 1033595772 | David Wallach | Contractor | 3100 Cone Manor Ln, Raleigh, NC 27613-6607 | 2015-08-05 |
| 1497167100 | Deanna Graves | Contractor | 700 Exposition Pl Ste 171, Raleigh, NC 27615-1563 | 2014-05-29 |
| 1619388469 | Sharon Clark | Contractor | 1115 Cove Bridge Rd, 101, Raleigh, NC 27604-8716 | 2014-05-14 |
| 1518289537 | Akin Bey | Contractor | 4932 Pebble Beach Dr Apt B, Raleigh, NC 27616-7037 | 2010-02-17 |
| Find all providers in RALEIGH | ||||
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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.