RICHARD DAVID WALLIS (NPI# 1336425982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336425982 |
| Entity Type | Individual |
| Full Name | RICHARD DAVID WALLIS |
| Practice Address |
6507 S Santa Fe Dr Bldg 22 Littleton CO 80120-2910 |
| Mailing Address |
155 Inverness Dr W Englewood CO 80112-5095 |
| Practice Telephone | 3037308858 |
| Mailing Telephone | 3037308858 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2018-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APN.0992126-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1866 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215036181 | Richard D Wallis Jr. | Physical Therapist | 7580 Northcliff Ave, Building B Suite 700, Brooklyn, OH 44144-3270 | 2006-09-21 |
| 1124005012 | Richard Gardner Wallis | Anesthesiology | 6196 Lake Gray Blvd, Suite 108, Jacksonville, FL 32244-7503 | 2005-12-30 |
| Street Address |
6507 S SANTA FE DR BLDG 22 |
| City | LITTLETON |
| State | CO |
| Zip Code | 80120-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156303 | Kelly Joy Brutsch | Counselor | 8191 Southpark Lane Suite 201, Littleton, CO 80120 | 2019-10-18 |
| 1902468309 | Infiniti Counseling, LLC | Clinic/Center | 4 W Dry Creek Circle, Littleton, CO 80120 | 2019-07-05 |
| 1437642642 | Brent Charles Mowery | Dentist | 209 W Littleton Blvd Ste B, Littleton, CO 80120 | 2018-06-12 |
| 1225525066 | Christopher Charles Miller | Counselor | 7851 S. Elati St., Suite 203, Littleton, CO 80120 | 2018-04-17 |
| 1417455890 | Cynthia Cline Mcrae | Counselor | 7921 Southpark Plaza, Grace Counseling, Suite 204, Littleton, CO 80120 | 2018-01-31 |
| 1780113175 | Janine Marie Lopez | Case Manager/Care Coordinator | 5500 S Sycamore, Littleton, CO 80120 | 2017-06-08 |
| 1952845588 | Hilary Sparrow Morris | Counselor | 991 Southpark Drive, #200, Cerescan, Littleton, CO 80120 | 2016-12-16 |
| 1760837132 | Supported Change,llc | Social Worker | 609 W Littleton Blvd Suite 201, Littleton, CO 80120 | 2016-05-04 |
| 1598123994 | Jarod Williams | Counselor | 8151 Southpark Ln Unit 250, Littleton, CO 80120 | 2016-02-01 |
| 1770948085 | Susan Jean Sylvester | Counselor | 609 West Littleton Blvd., Suite 201, Littleton, CO 80120 | 2015-12-31 |
| Find all providers in zip 80120 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471774 | Meditelecare of Colorado LLC | Nurse Practitioner | 1900 W Littleton Blvd, Littleton, CO 80120-2023 | 2020-06-12 |
| 1538706122 | Mile High Psychiatry LLC | Nurse Practitioner | 8089 S Lincoln St Ste 207, Littleton, CO 80122-2720 | 2019-12-03 |
| 1205168622 | Anna Michelle Libby | Nurse Practitioner | 7752 Elmwood St, Littleton, CO 80125-8828 | 2010-02-10 |
| 1881845881 | Carla Jean Farris | Nurse Practitioner | 1950 W Littleton Blvd Unit 117, Littleton, CO 80120-2000 | 2008-10-08 |
| 1265583975 | Wendy Dearborn Parker | Nurse Practitioner | 442 King Street, Littleton Counseling Associates, Littleton, MA 01460 | 2007-01-16 |
| 1942387493 | Mary Sue Stuart | Nurse Practitioner | 5500 S Sycamore St., Littleton, CO 80120-8201 | 2006-11-01 |
| 1730181272 | Linda Pearson | Nurse Practitioner | 191 E Orchard Rd, Littleton, CO 80121-8000 | 2005-08-15 |
| 1932710365 | Sarah Stockham Johnson | Nurse Practitioner | 8 W Dry Creek Cir Ste 207, Littleton, CO 80120-8082 | 2020-08-10 |
| 1275151250 | Katherine Frances Sabella Racine | Nurse Practitioner | 6507 S Santa Fe Dr, Littleton, CO 80120-2910 | 2020-07-07 |
| 1336787068 | South Metro Mental Health LLC | Nurse Practitioner | 7752 Elmwood St, Littleton, CO 80125-8828 | 2019-12-12 |
| Find all providers in LITTLETON | ||||
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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.