DR. COURTNEY NICOLE WALLACE (NPI# 1508396789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508396789 |
| Entity Type | Individual |
| Full Name | DR. COURTNEY NICOLE WALLACE |
| Credential | AUD, CCC-A, F/AAA |
| Practice Address |
2530 Chicago Ave Ste 450 Minneapolis MN 55404-4127 |
| Mailing Address |
202 7th St W Apt 515 Saint Paul MN 55102-3094 |
| Practice Telephone | 6128137610 |
| Mailing Telephone | (630) 303-3209 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2017-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285877217 | Courtney Brooke Wallace | Contractor | 5409 Harrington Grove Dr, Raleigh, NC 27613-5701 | 2009-04-06 |
| 1285102533 | Courtney Lynn Wallace | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2018-11-05 |
| 1548692189 | Courtney Creal Wallace | Counselor | 1432 S Shelby St, Louisville, KY 40217-1166 | 2013-08-06 |
| Street Address |
2530 CHICAGO AVE STE 450 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-4127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083835003 | Sivakumar Chinnadurai | Otolaryngology | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2007-05-01 |
| 1619578572 | Madeline Marie Smith | Audiologist | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2020-11-05 |
| 1407207558 | Kelsie Martin | Audiologist | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2016-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839715 | Thomas J Tedeschi | Audiologist | 150 S 5th St Ste 2300, Minneapolis, MN 55402-4223 | 2020-04-13 |
| 1538724612 | Elizabeth Mary Butler | Audiologist | 1155 E County Road E, Ste 100, Minneapolis, MN 55110-5191 | 2019-05-05 |
| 1700313681 | Hannah Catherine Erickson Herd | Audiologist | 701 25th Ave S Fl 2, Minneapolis, MN 55454 | 2017-05-22 |
| 1932529187 | Rachel Johnson | Audiologist | 2211 Park Avenue South, Minneapolis, MN 55404 | 2014-04-25 |
| 1528389988 | Jennifer Joan Nordberg | Audiologist | 2211 Park Avenue, Minneapolis, MN 55404 | 2010-06-18 |
| 1629223722 | Jennifer Jean Bormann | Audiologist | 8714 Lyndale Avenue South, Minneapolis, MN 55420 | 2008-11-18 |
| 1861649360 | Jessica Touray | Audiologist | 701 25th Ave S Ste 200, Minneapolis, MN 55454-1443 | 2008-08-26 |
| 1104025725 | Jane Elizabeth Carlstrom | Audiologist | 164 Pillsbury Drive S.e., 115 Shevlin Hall, Minneapolis, MN 55455-0279 | 2007-07-13 |
| 1134320419 | Sarah Kay Angerman | Audiologist | 164 Pillsbury Dr Se, 115 Shevlin Hall, Minneapolis, MN 55455-0279 | 2007-05-31 |
| 1861548893 | Susan Phillips | Audiologist | 4723 Hiawatha Ave, Minneapolis, MN 55406-3928 | 2007-01-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55404 |
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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.