MR. RICHARD DEAN WALLACE (NPI# 1750458402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750458402 |
| Entity Type | Individual |
| Full Name | MR. RICHARD DEAN WALLACE |
| Other Name | MR. RICHARD DEAN WALLACE |
| Credential | LICAC |
| Practice Address |
914 13th Ave South Great Falls MT 59405 |
| Practice Telephone | 4067613767 |
| Practice Fax Number | 4067613038 |
| Mailing Telephone | 4067613767 |
| Mailing Fax Number | 4067613038 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 133N00000X | Nutritionist | 450 | MT | Dietary & Nutritional Service Providers |
| X | 133V00000X | Dietitian, Registered | 450 | MT | Dietary & Nutritional Service Providers |
| X | 171100000X | Acupuncturist | 162 | MT | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811434400 | Richard Wallace | Registered Nurse | 4905 Hackamore Dr N, Colorado Springs, CO 80918-2632 | 2017-01-20 |
| 1023242112 | Richard Lance Wallace | Physical Therapist | 1034 Buchanan Bridge Rd, Chesterfield, SC 29709-6154 | 2009-05-05 |
| 1063656262 | Richard Scott Wallace | Social Worker | 10625 Redmond Rd, Austin, TX 78739-1654 | 2009-05-01 |
| 1710105911 | Richard Franklin Wallace | Marriage & Family Therapist | 3341 M St, Merced, CA 95348-2714 | 2007-04-23 |
| 1326199043 | Richard J. Wallace | Counselor | 1930 Stuart St, Berkeley, CA 94703-2215 | 2007-01-16 |
| 1427155001 | Richard Lange Wallace | Psychiatry & Neurology | 8858 Scenic Bay Dr, Las Vegas, NV 89117-1026 | 2006-09-17 |
| 1275586448 | Richard Peterkin Wallace | Family Medicine | 1001 S Fort Harrison Ave, Suite 101, Clearwater, FL 33756-3941 | 2006-05-18 |
| 1881656940 | Richard M. Wallace | Specialist | 925 Highland Blvd., Suite 1180, Bozeman, MT 59715 | 2006-04-04 |
| 1972596443 | Richard J Wallace | Dentist | 20921 E Smoky Hill Rd, Suite A, Centennial, CO 80015 | 2005-08-30 |
| 1154678332 | Richard Paul Wallace | Pharmacist | Psc 80, Box 13059, Apo, AP 96367-9998 | 2012-08-07 |
| Street Address |
914 13TH AVE SOUTH |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| Taxonomy Code | 133N00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation. |
| Notes: Source: (1) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356789598 | Hannah C Cham-a-koon | Nutritionist | 1101 26th St S, Great Falls, MT 59405-5161 | 2013-06-10 |
| 1538478581 | Katie Mikel Wichman | Nutritionist | 1101 26th St S, Great Falls, MT 59405-5161 | 2010-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674191 | Sarah Jayne St Clair | Nutritionist | 1102 S 6th Ave, Bozeman, MT 59715-0701 | 2020-06-18 |
| 1801370192 | Candice Marie Vann | Nutritionist | 362 Annie Glade Dr, Bozeman, MT 59718-7685 | 2018-09-21 |
| 1699172932 | Julia Coyne | Nutritionist | 2616 Locust St, Butte, MT 59701-5029 | 2014-12-02 |
| 1053603746 | Debra Lee Fix | Nutritionist | 383 North 17th Street, Forsyth, MT 59327 | 2011-05-12 |
| 1962710046 | Christina Marie Skinner | Nutritionist | 867 1st Rd Ne, Fairfield, MT 59436-9141 | 2010-09-22 |
| 1447498217 | Mary Margaret Debernardis | Nutritionist | 12345 Gooch Hill Rd, Gallatin Gateway, MT 59730-8506 | 2009-02-01 |
| 1992904569 | Rosemary K. Newman | Nutritionist | 14679 Brackett Creek Rd, Bozeman, MT 59715-8232 | 2007-07-13 |
| 1386710366 | Jerrie Lynn Nelson | Nutritionist | 9340 S Frontage Rd, Billings, MT 59101-6100 | 2006-11-28 |
| 1437764206 | Ashley Barto | Nutritionist | 760 Hospital Circle, Browning, MT 59417 | 2020-09-09 |
| 1194372144 | Nicole Marie Cirilli | Nutritionist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2019-08-23 |
| Find all providers with the same taxonomy | ||||
| City | GREAT FALLS |
| Zip Code | 59405 |
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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.