SCOTT MICHAEL WALLACE (NPI# 1922441880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922441880 |
Entity Type | Individual |
Full Name | SCOTT MICHAEL WALLACE |
Credential | M.D. |
Practice Address |
75 Pringle Way Ste 300 Reno NV 89502-1464 |
Mailing Address |
780 Kuenzli St Ste 202 Reno NV 89502-0845 |
Practice Telephone | 7759825000 |
Practice Fax Number | 7759823900 |
Mailing Telephone | 7759825262 |
Mailing Fax Number | 7759825496 |
Enumeration Date | 2013-04-10 |
Last Update Date | 2016-09-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | 16487 | NV | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CAQH | 13804974 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275809899 | Scott Andrew Wallace | Student in an Organized Health Care Education/Training Program | Navy Medicine Support Command Attn: Med Staff Services, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2012-03-28 |
1184996399 | Scott D Wallace | Social Worker | 63 Glenwood St, Lowell, MA 01852-3007 | 2012-02-02 |
1629139563 | Scott Matthew Wallace | Chiropractor | 8960 W Cheyenne Ave, Suite 110, Las Vegas, NV 89129-8929 | 2006-12-13 |
1770655342 | Scott G Wallace | Chiropractor | 2515 Crosby Ave, Klamath Falls, OR 97603-4553 | 2006-11-15 |
1558381822 | Scott Christopher Wallace | Anesthesiology | Po Box 112, Muncie, IN 47308-0112 | 2006-07-20 |
1831611839 | Scott Christopher Wallace | Nurse Practitioner | 1900 S Main St, Findlay, OH 45840-1214 | 2017-07-11 |
1104359975 | Scott Robert Wallace | Psychiatry & Neurology | 103 N Loop 499, Harlingen, TX 78550-2557 | 2017-04-07 |
1134414220 | Scott Eric Wallace | Pharmacist | 1214 N Market Blvd, Suite C, Sacramento, CA 95834-2931 | 2011-06-16 |
1568755114 | Scott Wallace | Technician, Other | 4801 Reading St, Dallas, TX 75247-6716 | 2011-05-16 |
1265613855 | Scott Arthur Wallace | Physician Assistant | 3643 N Roxboro St, Durham Regional Hospital Emergency Department, Durham, NC 27704-2702 | 2007-11-25 |
Street Address |
75 PRINGLE WAY STE 300 |
City | RENO |
State | NV |
Zip Code | 89502-1464 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043218431 | Jeffrey K Beall | Otolaryngology | 75 Pringle Way, Suite 509, Reno, NV 89502-1464 | 2005-07-11 |
1497238257 | Tiffany Broce | Nurse Practitioner | 75 Pringle Way, Reno, NV 89502-1464 | 2018-09-07 |
1346772910 | Laura Michelle Orange | Registered Nurse | 75 Pringle Way, Reno, NV 89502-1464 | 2017-04-01 |
1285171249 | Sierra Infectious Disease | Clinic/Center | 75 Pringle Way, Suite 705, Reno, NV 89502-1464 | 2017-01-27 |
1023550704 | Heather Nicole Carroll | Nurse Practitioner | 75 Pringle Way, Suite 512, Reno, NV 89502-1464 | 2016-11-10 |
1548712771 | Gomez Kozar Mcelreath Smith | Nurse Practitioner | 75 Pringle Way, Suite 1002, Reno, NV 89502-1464 | 2016-11-04 |
1407219801 | Amy Gardner | Physician Assistant | 75 Pringle Way, Suite 804, Reno, NV 89502-1464 | 2016-04-01 |
1417320540 | Sierra Pediatric Blood and Cancer Consortium | Pediatrics | 75 Pringle Way, Reno, NV 89502-1464 | 2015-11-11 |
1306216163 | Karen E Dosh | Registered Nurse | 75 Pringle Way, Suite 1002, Reno, NV 89502-1464 | 2015-10-05 |
1811331713 | Chiyo Wendy Takehara | Family Medicine | 75 Pringle Way, Suite 601, Reno, NV 89502 | 2013-04-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992314264 | State of Nevada | Community/Behavioral Health | 4600 Kietzke Lane Bldg D, Reno, NV 89502 | 2020-07-23 |
1447879259 | Ryan Johnson | Student in an Organized Health Care Education/Training Program | 1155 Mill St. W-11, Reno, NV 89502 | 2020-04-11 |
1396378063 | Domingko Loney | Chore Provider | 1325 Air Motive Wat St 262, Reno, NV 89502 | 2020-02-20 |
1053954842 | Derek Craig | Home Health Aide | 1000 Havard Way #29, Reno, NV 89502 | 2019-10-24 |
1477108124 | Marisa Rachael Traversie | Nurse Practitioner | 910 Vista Boulevard, Sparks, NV 89502 | 2019-08-08 |
1912564675 | Patrick Llewellyn Merrill | Social Worker | 975 Kirman Ave - Ch 116, Reno, NV 89502 | 2019-05-28 |
1881154706 | Naresh Kumar Veerabattini | Student in an Organized Health Care Education/Training Program | 1155 Mill St, Renown Regional Medical Center, W11 Academic Department Offices, Reno, NV 89502 | 2019-03-25 |
1053899187 | Daphne London | Behavioral Analyst | 1325 Airmotive Way Ste 260, Reno, NV 89502 | 2018-07-31 |
1790271609 | Jennifer J Padolina | Optometrist | 2296 Kietzke Ln, Reno, NV 89502 | 2018-07-03 |
1336630185 | Lindsey Cherie Cooper | Technician | 3563 Sol Grande Ct, Reno, NV 89502 | 2018-05-27 |
Find all providers in zip 89502 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437528825 | Tammy Roesler Md PC | Pediatrics | 3725 Lakeside Dr, Reno, NV 89509-5239 | 2015-09-16 |
1952703779 | Mark E Swanson | Pediatrics | 5190 Neil Rd., #215, Reno, NV 98502 | 2014-09-24 |
1245596055 | The Medical Profession, LLC | Pediatrics | 5301 Reno Corporate Dr., Reno, NV 89511 | 2012-04-05 |
1972874170 | Mayenne Alonzo Karelitz | Pediatrics | 5010 Ventana Pkwy, Reno, NV 89511-5605 | 2012-01-19 |
1578859377 | Nancy Heinz Sader | Pediatrics | 7215 Lingfield Dr, Reno, NV 89502-9662 | 2011-06-21 |
1114217502 | Megan Jean Dory | Pediatrics | 645 N Arlington Ave Ste 620, Reno, NV 89503-4444 | 2011-04-19 |
1699917294 | Christina Elise Raman | Pediatrics | 6350 Mae Anne Ave Ste 3, Reno, NV 89523-4718 | 2009-03-27 |
1194970921 | The Speicher Medical Grp | Pediatrics | 75 Pringle # 301, Reno, NV 89502 | 2008-11-20 |
1235399767 | Ron Max Aryel | Pediatrics | 6548 South Mccarran Blvd., Suite A, Reno, NV 89509-6150 | 2008-06-09 |
1720276587 | Shaji Mathew Md., P.C. | Pediatrics | 3639 Warren Way, Suite #100, Reno, NV 89509 | 2007-10-05 |
Find all providers in RENO |
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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.