DR. RICHARD M. WALLACE (NPI# 1881656940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881656940 |
| Entity Type | Individual |
| Full Name | DR. RICHARD M. WALLACE |
| Credential | M.D. |
| Practice Address |
925 Highland Blvd. Suite 1180 Bozeman MT 59715 |
| Practice Telephone | 4065878631 |
| Practice Fax Number | 4065871343 |
| Mailing Telephone | 4065878631 |
| Mailing Fax Number | 4065871343 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 6907 | MT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0144690 | 05 | |
| MT | 0089427 | 05 |
| 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 |
| 1750458402 | Richard Dean Wallace | Nutritionist | 914 13th Ave South, Great Falls, MT 59405 | 2006-11-29 |
| 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 |
| 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 |
925 HIGHLAND BLVD., SUITE 1180 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265883037 | Molly Kathleen Smith | Specialist | 642 S. Cottonwood Rd., Suite 2, Bozeman, MT 59718 | 2016-06-23 |
| 1174986533 | Jessie May Campbell | Specialist | 24 S Willson Ave Ste 3, Bozeman, MT 59715-4609 | 2016-04-03 |
| 1235562893 | Amy Slabaugh | Specialist | 2050 Fairway Dr Ste 111, Bozeman, MT 59715-5819 | 2013-08-18 |
| 1174962542 | Rocky Mountain Vein Clinic Bozeman, Inc | Specialist | 822 Stoneridge Dr Ste 2, Bozeman, MT 59718-7047 | 2013-06-19 |
| 1629333109 | Cindy Ann Leavitt | Specialist | 3060 Upper Rainbow Rd, Bozeman, MT 59718-7648 | 2012-07-10 |
| 1194057109 | Healing Waters Wellness Center, Inc | Specialist | 1015 W. Mendenhall, Suite A-2, Bozeman, MT 59715 | 2010-02-02 |
| 1457591216 | Nathaniel Eric Wooten IIi | Specialist | 4580 Conestoga Cir, Suite A, Bozeman, MT 59715-9216 | 2009-03-05 |
| 1609014349 | Georgia K Cold | Specialist | 1015 W Mendenhall St Ste A2, Bozeman, MT 59715-3213 | 2009-02-03 |
| 1174735534 | Douglas Wayne Alvord | Specialist | 221 Ridge Trl, Bozeman, MT 59715-9253 | 2007-05-05 |
| 1770651226 | Kenneth S. Keyes | Specialist | 3090 Bridger Hills Dr, Bozeman, MT 59715-7653 | 2006-12-01 |
| Find all providers in BOZEMAN | ||||
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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.