MEGAN WALLACE (NPI# 1386181022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386181022 |
| Entity Type | Individual |
| Full Name | MEGAN WALLACE |
| Practice Address |
2240 W Park Place Blvd Ste A Stone Mountain GA 30087-3543 |
| Practice Telephone | 7707715222 |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN231247 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1390 Montreal Rd, Suite 180, Tucker, GA 300848143 | 4044464600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447725957 | Megan Elizabeth Wallace | Behavior Technician | 784 Kelsall Dr, Richmond Hill, GA 31324-7706 | 2018-10-11 |
| 1972838878 | Megan Ann Wallace | Speech-Language Pathologist | 1000 W 15th St, Unit 224, Chicago, IL 60608-1882 | 2009-10-09 |
| 1003385170 | Megan Nicol Wallace | Speech-Language Pathologist | 1628 19th St, Lubbock, TX 79401-4895 | 2018-11-19 |
| 1780123521 | Megan E. Wallace | Physician Assistant | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2017-02-13 |
| 1326420720 | Megan Wallace | Social Worker | 67 President St, Msc 861, Iop 2 South, Charleston, SC 29425-5712 | 2015-06-22 |
| 1174911168 | Megan Wallace | Nurse Anesthetist, Certified Registered | 375 Dixmyth Ave, Cincinnati, OH 45220-2475 | 2014-12-30 |
| 1881095933 | Megan Wallace | Counselor | 110 E Main St, Ottumwa, IA 52501-2910 | 2014-09-09 |
| 1306252473 | Megan Wallace | Occupational Therapist | 162 W 72nd St, 5th Floor, New York, NY 10023-3300 | 2014-07-09 |
| 1306192810 | Megan M Wallace | Audiologist | 2502 E Empire St, Bloomington, IL 61704-3738 | 2012-08-02 |
| 1518253905 | Megan Wallace | Speech-Language Pathologist | 6180 Brockton Ave, Suite 202, Riverside, CA 92506-2228 | 2011-06-23 |
| Street Address |
2240 W PARK PLACE BLVD STE A |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087-3543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528689155 | Dahnide Marie Taylor | Nurse Practitioner | 667 Lakewater Estates Ln, Stone Mountain, GA 30087-4999 | 2020-05-05 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1629580196 | Lilian Mugwede | Nurse Practitioner | 1023 Privy Ln, Stone Mountain, GA 30083-4769 | 2017-10-24 |
| 1558765974 | Kimberly Fitzgerald | Nurse Practitioner | 382 Summer Glen Ct, Stone Mountain, GA 30087-5500 | 2014-10-14 |
| 1255459335 | Kathalina Vershelle Lacoste | Nurse Practitioner | 5049 Highland Hills Pkwy, Stone Mountain, GA 30088-3740 | 2007-03-27 |
| 1265411094 | Dawn Ledford Parker | Nurse Practitioner | 7207 Rockbridge Rd, Stone Mountain, GA 30087-6320 | 2006-01-11 |
| 1245230010 | Catherine M. Kilgore | Nurse Practitioner | 1505 Lilburn Stone Mtn Rd., Suite 100, Stone Mountain, GA 30087 | 2005-07-22 |
| 1508406182 | Patrice M Walton | Nurse Practitioner | 1227 Rockbridge Rd, Stone Mountain, GA 30087-3064 | 2020-01-10 |
| 1730653619 | Chidi D Ikeokwu | Nurse Practitioner | 5329 Memorial Dr, Stone Mountain, GA 30083-3212 | 2019-01-14 |
| 1205316148 | Peter Claver Inyang | Nurse Practitioner | 5300 Memorial Drive, Suite 112, Stone Mountain, GA 30083 | 2018-08-20 |
| Find all providers in STONE MOUNTAIN | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
Please comment or provide details below to improve the information on MEGAN 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.