MR. BRIAN LESLIE WALLACE (NPI# 1790888501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790888501 |
| Entity Type | Individual |
| Full Name | MR. BRIAN LESLIE WALLACE |
| Credential | MS PT |
| Practice Address |
901 Halstead Blvd Elizabeth City NC 27909-6920 |
| Mailing Address |
1105 W Church St Elizabeth City NC 27909-4609 |
| Practice Telephone | 2523380137 |
| Mailing Telephone | 2523385948 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 10128 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093866121 | Brian Wallace | Dentist | 781 S Lake Dr, Suite 1, Prestonsburg, KY 41653-1340 | 2007-01-16 |
| 1801864350 | Brian Wallace | Internal Medicine | 9005 Kilbride Rd, Baltimore, MD 21236-2017 | 2006-03-10 |
| 1831198811 | Brian David Wallace | Radiology | 1100 Brookhaven Rd, Franklin, KY 42134-2746 | 2005-07-20 |
| 1861939845 | Brian Wallace | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2017-01-27 |
| 1114378759 | Brian Charles Wallace | Physician Assistant | 125 W Catawba Ave, Mount Holly, NC 28120-1601 | 2016-06-24 |
| 1154677359 | Brian Venson Wallace | Physical Therapist | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2012-07-25 |
| 1598083495 | Brian William Wallace | Chiropractor | 139 Morristown Rd, Bernardsville, NJ 07924-2633 | 2010-05-17 |
| 1790017028 | Brian Edward Wallace | Anesthesiology | 400 E Pioneer Ave, Suite 101, Puyallup, WA 98372-3255 | 2010-02-11 |
| 1518118462 | Brian Robert Wallace | Orthopaedic Surgery | 1250 Pine Ridge Rd, Suite 203, Naples, FL 34108-8913 | 2008-10-08 |
| 1518124627 | Brian Scott Wallace | Emergency Medicine | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2008-05-18 |
| Street Address |
901 HALSTEAD BLVD |
| City | ELIZABETH CITY |
| State | NC |
| Zip Code | 27909-6920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053423913 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2006-08-31 |
| 1194381681 | Citadel Elizabeth City LLC | Respite Care | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2019-05-10 |
| 1275952616 | Jubeth Concepcion | Physical Therapist | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2014-04-14 |
| 1265721484 | Lauri Ann Cuozzo | Occupational Therapy Assistant | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2011-03-29 |
| 1275708976 | Lisa L Harris | Physical Therapy Assistant | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2008-04-24 |
| 1326213059 | Jennie L Roach | Occupational Therapist | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2008-04-24 |
| 1881869519 | Laura Marguerite Crummey | Physical Therapist | 901 Halstead Blvd, Elizabeth City, NC 27909-6920 | 2008-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482177 | Leslie Treherne-fayton Dds Pllc | Dentist | 3875 Conlon Way Ste A, Elizabeth City, NC 27909 | 2020-03-13 |
| 1053829077 | Kaitlyn Daniels | Counselor | 1825 West City Drive, Suites A&b, Elizabeth City, NC 27909 | 2018-01-11 |
| 1487183778 | Traniqua Mccullen | Social Worker | 314 Orchard Drive, Elizabeth City, NC 27909 | 2017-06-08 |
| 1760938401 | Lauren Noele Schaefer | Physical Therapist | 615 S Hughes Boulevard, Unit B, Elizabeth City, NC 27909 | 2016-09-01 |
| 1588023279 | Regina Mccoy | Nurse Practitioner | 1507 N Road St Ste 3, Elizabeth City, NC 27909 | 2016-02-23 |
| 1750753760 | Mark C. ''chris'' Patterson | Physician Assistant | Coast Guard Base Elizabeth City, 1664 Weeksville Road, Building 128, Elizabeth City, NC 27909 | 2015-10-29 |
| 1770963365 | Harlan Bradley Hurdle | Pharmacist | 104 Breezewood Drive, Elizabeth City, NC 27909 | 2015-06-09 |
| 1558779298 | Wilkiam Wilson | Counselor | 1290 Halstead Blvd, Elizabeth City, NC 27909 | 2014-07-25 |
| 1871919886 | Courtney Bunch | Specialist/Technologist | 1680 Cedar Point Circle, Elizabeth City, NC 27909 | 2014-03-14 |
| 1790100832 | The Power of U | Community/Behavioral Health | 1023 Us17s Suite 1, Elizabeth City, NC 27909 | 2014-02-26 |
| Find all providers in zip 27909 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760938401 | Lauren Noele Schaefer | Physical Therapist | 615 S Hughes Boulevard, Unit B, Elizabeth City, NC 27909 | 2016-09-01 |
| 1851667745 | Crystal L Copeland | Physical Therapist | 125 Lee Cir, Elizabeth City, NC 27909-7946 | 2012-03-26 |
| 1013233923 | Beverly Armstrong Smith | Physical Therapist | 615 S Hughes Blvd Ste B, Elizabeth City, NC 27909-4784 | 2010-04-16 |
| 1316986524 | Shannon Carey Mustico | Physical Therapist | 101 Medical Dr, Elizabeth City, NC 27909-3361 | 2006-06-05 |
| 1386602688 | Roscoe Waylon Joyner IIi | Physical Therapist | 806 W Ehringhaus St, Elizabeth City, NC 27909-6935 | 2006-05-03 |
| 1811597107 | Caroline Poage | Physical Therapist | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2020-10-27 |
| 1215549647 | Kelley Stamey | Physical Therapist | 101 Medical Dr, Elizabeth City, NC 27909-3361 | 2020-08-18 |
| 1457907909 | Harrison Spalding | Physical Therapist | 101 Medical Dr, Elizabeth City, NC 27909-3361 | 2019-08-12 |
| 1124556758 | Justyn Jay Yager | Physical Therapist | 101 Medical Dr, Elizabeth City, NC 27909-3361 | 2017-05-26 |
| 1124485453 | Daniel David Metzger | Physical Therapist | 405 E Main St, Unit 2, Elizabeth City, NC 27909-4427 | 2016-01-17 |
| Find all providers in ELIZABETH CITY | ||||
| City | ELIZABETH CITY |
| Zip Code | 27909 |
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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.