JESSICA FAYE WALLACE (NPI# 1306920780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306920780 |
| Entity Type | Individual |
| Full Name | JESSICA FAYE WALLACE |
| Credential | PA-C |
| Practice Address |
3020 14th St Nw Washington DC 20009-6865 |
| Practice Telephone | 2027454300 |
| Practice Fax Number | 2027452510 |
| Mailing Telephone | 2027454300 |
| Mailing Fax Number | 2027452510 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-00640 | NC | Physician Assistants & Advanced Practice Nursing 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 |
3020 14TH ST NW |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20009-6865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154392926 | Christine Jeanette Lepoutre | Psychiatry & Neurology | 3020 14th St Nw, Upper Cardozo Health Center, Unity Health Care, Washington, DC 20009-6865 | 2006-01-30 |
| 1235756669 | Rosanna Maribel Sanchez John | Counselor | 3020 14th St Nw, Washington, DC 20009-6865 | 2020-07-01 |
| 1578028460 | Katherine Maestre Caro | Counselor | 3020 14th St Nw, Washington, DC 20009-6865 | 2019-02-05 |
| 1992297378 | Shakita Chavette Mcbrayer | Technician | 3020 14th St Nw, Washington, DC 20009-6865 | 2018-06-01 |
| 1205345113 | Maariya Bassa | Advanced Practice Midwife | 3020 14th St Nw, Washington, DC 20009-6865 | 2017-09-22 |
| 1306361225 | Kyle Wehrend | Social Worker | 3020 14th St Nw, Washington, DC 20009-6865 | 2017-08-11 |
| 1790219319 | Yodit Beru | Internal Medicine | 3020 14th St Nw, Washington, DC 20009-6865 | 2017-04-20 |
| 1760928733 | Unity Health Care Inc | Pharmacy | 3020 14th St Nw, Washington, DC 20009-6865 | 2017-01-13 |
| 1023460573 | Sidalia Reed | Dentist | 3020 14th St Nw, Washington, DC 20009-6865 | 2016-07-08 |
| 1679936033 | Hannah Ilene Sandler Herman | Family Medicine | 3020 14th St Nw, Washington, DC 20009-6865 | 2016-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724515 | Ana Serra | Social Worker | Mary's Center, 2333 Ontario Rd Nw, Washington, DC 20009 | 2020-06-10 |
| 1124596317 | Javan Anti Aging and Wellness Institute | Clinic/Center | 1626 U St Nw, Washington, DC 20009 | 2018-11-06 |
| 1477052272 | Shaw Family Dentistry Pllc | Dentist | 1515 U Street Nw, Suite A1 C1, Washington Dc, DC 20009 | 2018-02-07 |
| 1942728597 | Emily Schwaber | Speech-Language Pathologist | 5185 Macarthur Boulevard Suite 101, Washington, DC 20009 | 2017-09-05 |
| 1649792581 | Kalorama Pharmacy Inc. | Pharmacy | 1841 Columbia Rd Nw, Washington, DC 20009 | 2017-07-12 |
| 1700313707 | Salome Fomukong | Home Health Aide | 1752 Columbia Rd #2, Tierno Care Home Health Agency, Washington, DC 20009 | 2017-05-22 |
| 1912432436 | Mcclain Eyewear | Eyewear Supplier (Equipment, not the service) | 1514 U Street Nw, Washington, DC 20009 | 2017-04-21 |
| 1487195624 | Jasmine Thomas | Home Health Aide | 1440 W St Nw #b1, Washington, DC 20009 | 2017-03-20 |
| 1760923361 | Natasha Khawaja | Family Medicine | Upper Cardozo Community Health Center, 320 14th Street Nw, Washington, DC 20009 | 2017-03-15 |
| 1134672520 | Margaret Ache Tata Tanwani | Home Health Aide | 1752 Columbia Rd, North West Washington Dc, North West Washington, DC 20009 | 2016-08-02 |
| Find all providers in zip 20009 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265065619 | Lukas James Williams | Physician Assistant | 110 Irving St Nw Ste 3b-55, Washington, DC 20010-3017 | 2020-02-13 |
| 1841784691 | Amanda-gay A Edwards | Physician Assistant | 3 Washington Cir Nw Ste 305, Washington, DC 20037-2311 | 2018-06-15 |
| 1588177752 | Shelly Powers | Physician Assistant | 6th and Bryant St Nw Annex 1 #116, Washington, DC 20059-0001 | 2017-11-10 |
| 1154832046 | Sarah Elizabeth Walters-slezak | Physician Assistant | 470 Johnson Rd Ste 160, Washington, PA 15301-8968 | 2017-10-18 |
| 1174985220 | Robert Matthew Cronin | Physician Assistant | 3800 Reservoir Rd. Nw, 4phc, Washington, DC 20007 | 2016-03-27 |
| 1639540529 | Jennifer Quyen Tran | Physician Assistant | 332 18th Pl Ne Apt 4, Washington, DC 20002-6650 | 2015-10-17 |
| 1487023511 | Christina Russo | Physician Assistant | 2021 K St Nw Ste 512, Washington, DC 20006-1003 | 2015-09-18 |
| 1194148031 | Luminita Ellis | Physician Assistant | 3700 N Capitol St Nw # 252, Washington, DC 20011-8400 | 2014-01-29 |
| 1518235167 | Anoa Gibson-hunter | Physician Assistant | 4221 Argyle Ter Nw, Washington, DC 20011-4241 | 2011-12-11 |
| 1295014330 | Annise Claude | Physician Assistant | 2021 K St Nw Ste 210, Washington, DC 20006-1003 | 2011-08-08 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20009 |
Please comment or provide details below to improve the information on JESSICA FAYE WALLACE.
| 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.