MR. TIMOTHY WALLACE (NPI# 1619527611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619527611 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY WALLACE |
| Credential | CDCA |
| Practice Address |
774 Internet Dr Columbus OH 43207-2589 |
| Practice Telephone | 6144435454 |
| Mailing Telephone | 6144435454 |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063438307 | Timothy Mark Wallace | Chiropractor | 4357 Phelan Rd, Phelan, CA 92371-7675 | 2006-07-13 |
| 1437149739 | Timothy R Wallace | Psychologist | 125 Nashua Street, Spaulding Rehab Hospital, Boston, MA 02114-1198 | 2005-10-27 |
| 1396987657 | Timothy Brian Wallace II | Anesthesiology | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2009-04-01 |
| 1003072414 | Timothy Thomas Wallace Jr. | Registered Nurse | 10000 Brecksville Rd, Brecksville, OH 44141-3204 | 2008-08-05 |
| 1275725384 | Timothy R Wallace | Family Medicine | 855 N Westhaven Dr, Oshkosh, WI 54904-7668 | 2007-08-13 |
| 1033328703 | Timothy J Wallace | Radiology | 401 College St, Richmond, VA 23298-5017 | 2007-05-21 |
| 1720013121 | Timothy M Wallace | Pathology | 36500 Aurora Dr, Summit, WI 53066-4899 | 2006-07-12 |
| 1841215902 | Timothy Brian Wallace | Anesthesiology | 6605 Abercorn St, Suite 108, Savannah, GA 31405-5815 | 2006-07-12 |
| 1700850674 | Timothy Wallace | Physician Assistant | 450 Clarkson Ave, Box 56, Brooklyn, NY 11203-2056 | 2006-02-15 |
| Street Address |
774 INTERNET DR |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43207-2589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083802961 | Emily Lynn Lowe | Social Worker | 774 Internet Dr, Columbus, OH 43207-2589 | 2007-10-04 |
| 1326695560 | Marissa Minette | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-08-22 |
| 1396203576 | Savannah C Flannery | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-03-07 |
| 1689132763 | Brandon Sufronko | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-03-07 |
| 1093273104 | Zachary Johnson | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-03-07 |
| 1750849915 | Shay Greenwalt | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-03-06 |
| 1790243079 | Jennifer Caro | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2019-03-06 |
| 1831675370 | Samantha Angeline Ottney | Social Worker | 774 Internet Dr, Columbus, OH 43207-2589 | 2018-07-18 |
| 1497245468 | Morgan Ashley Brenner | Social Worker | 774 Internet Dr, Columbus, OH 43207-2589 | 2018-05-15 |
| 1184130973 | Jessica Ann Vogel | Case Manager/Care Coordinator | 774 Internet Dr, Columbus, OH 43207-2589 | 2017-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366947913 | Mary Elise Hanks | Internal Medicine | Osumc/nationwide Children's Med-ped Residency Program, 1405 S. High St, Columbus, OH 43207 | 2018-03-27 |
| 1699279323 | Timothy Ming-li Pian | Internal Medicine | Internal Medicine-pediatric Residency Program, 1405 S. High Street, Columbus, OH 43207 | 2018-03-19 |
| 1093245763 | Royce Scott | Home Health | 254 E. Barthman Ave, Columbus, OH 43207 | 2017-06-15 |
| 1497207930 | Vernon C Murphy Jr. | Counselor | 1430 S High St Suite 112, Columbus, OH 43207 | 2016-11-01 |
| 1669825931 | Ayamba Roselyn Tanyi | Social Worker | 1791 Alum Creek Drive, Columbus, OH 43207 | 2016-07-21 |
| 1629421268 | Tiffany Dawn Hinkle | Counselor | 1430 S. High St, Suite 112, Columbus, OH 43207 | 2016-07-19 |
| 1457714933 | Matthew Isaac Lyons | Internal Medicine | 1405 S. High St., Osu/nch Internal Medicine-pediatric Residency Prog., Columbus, OH 43207 | 2016-04-01 |
| 1053712976 | A Plus Children's Academy Community School | Local Education Agency (LEA) | 110 Obetz Rd., Columbus, OH 43207 | 2014-09-10 |
| 1407274301 | William Hamilton Marshall V | Student in an Organized Health Care Education/Training Program | 1405 South High St, South High Primary Care Center, Columbus, OH 43207 | 2014-03-29 |
| 1912249665 | Laura Romcevich | Internal Medicine | 700 Children's Dr. Ed650a, Osu/nch Internal Medicine-pediatric Residency Prog., Columbus, OH 43207 | 2013-03-20 |
| Find all providers in zip 43207 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528775 | Trinka Louise Glenn | Case Manager/Care Coordinator | 6400 E Broad St # F14, Columbus, OH 43213-2086 | 2020-11-02 |
| 1164022182 | George Atta Owusu | Case Manager/Care Coordinator | 407 Lemery Dr, Columbus, OH 43213-4482 | 2020-10-28 |
| 1669070280 | Abu Daniel Kamara | Case Manager/Care Coordinator | 2935 E Main St 9721, Columbus, OH 43209 | 2020-10-15 |
| 1346857513 | Claire Dawson | Case Manager/Care Coordinator | 2546 Billingsley Road, Columbus, OH 43235-1976 | 2020-09-30 |
| 1952918484 | Andrea Y Daniel | Case Manager/Care Coordinator | 6040 Walters Loop, Columbus, GA 31907-5368 | 2020-09-29 |
| 1962027839 | Julius A Michael | Case Manager/Care Coordinator | 1966 Hampstead Dr, Columbus, OH 43229-2714 | 2020-06-16 |
| 1912528035 | Deshaun Brown | Case Manager/Care Coordinator | 6470 Cove Creek Ct, Columbus, GA 31909-3400 | 2020-04-29 |
| 1467072074 | Medforall | Case Manager/Care Coordinator | 1500 W 3rd Ave Ste 111, Columbus, OH 43212-2890 | 2020-04-23 |
| 1366071763 | Tianna S Roberts | Case Manager/Care Coordinator | 1111 Mediterranean Ave, Columbus, OH 43229-2509 | 2020-04-07 |
| 1871127720 | Areil Mackenzie | Case Manager/Care Coordinator | 2921 Parkside Rd, Columbus, OH 43204-2543 | 2020-03-01 |
| Find all providers in COLUMBUS | ||||
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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.