DR. JESSICA ANN WALLENMEYER (NPI# 1992095640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992095640 |
| Entity Type | Individual |
| Full Name | DR. JESSICA ANN WALLENMEYER |
| Credential | M.D. |
| Practice Address |
2109 N Kelly Ave Edmond OK 73003-3908 |
| Practice Telephone | 4055138880 |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2015-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 31309 | OK | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | P6106 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
2109 N KELLY AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73003-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945202 | Korbin Hally | Dentist | 2600 Tayler Street, Edmond, OK 73003 | 2020-06-04 |
| 1003448325 | Diagnostic Resources, LLC | Physical Medicine & Rehabilitation | 1641 Saratoga Way, Edmond, OK 73003 | 2020-02-05 |
| 1861904021 | Rhonda Diane Pennington | Occupational Therapist | 515 S Santa Fe Ave Ste 103, Edmond, OK 73003 | 2017-10-27 |
| 1588173744 | Hpc Holdings LLC | Clinic/Center | 813 W Covell Rd, Edmond, OK 73003 | 2017-09-20 |
| 1194243568 | Nightengale Chiropractic, LLC | Chiropractor | 2616 Covell Village Dr Ste. 120, Edmond, OK 73003 | 2017-09-06 |
| 1104274927 | Bonsu Osei Asibey | Case Manager/Care Coordinator | 1301 Craig Blvd, Edmond, OK 73003 | 2016-06-02 |
| 1215390810 | Prince Yebo | Case Manager/Care Coordinator | 1817 Redland Dr, Edmond, OK 73003 | 2016-03-31 |
| 1548621691 | Charles Loftis | Physical Therapist | 1321 Fretz Drive, 100, Edmond, OK 73003 | 2016-03-17 |
| 1487013801 | Courage Counseling Center | Community/Behavioral Health | 1400 S. Fretz Ave, Suite 1400, Edmond, OK 73003 | 2016-02-12 |
| 1669889887 | Shannon Gogel | Occupational Therapy Assistant | 1309 Val Genes Rd, Edmond, OK 73003 | 2014-07-21 |
| Find all providers in zip 73003 | ||||
| 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 |
|---|---|---|---|---|
| 1104967900 | Brooke A Nida | Pediatrics | 1700 S Renaissance Blvd, Edmond, OK 73013 | 2007-02-12 |
| 1841347838 | Wendy Y. Pitt | Pediatrics | 3301 Cheyenne Villa Cir, Edmond, OK 73013-0601 | 2007-01-04 |
| 1205925864 | Justin Joel Boe | Pediatrics | 1408 Glenolde Pl, Edmond, OK 73003-2668 | 2006-10-12 |
| 1497780308 | Kerri Kathleen Barclay | Pediatrics | 2421 Silverfield Ln, Edmond, OK 73003-1503 | 2006-07-11 |
| 1164482501 | Kimberly Edgmon | Pediatrics | 2820 N Kelly Ave, Suite 200, Edmond, OK 73003-3007 | 2006-03-27 |
| 1144295775 | Susan T Redwine | Pediatrics | 200 N Bryant Ave, Edmond, OK 73034-6273 | 2006-02-17 |
| 1114992740 | Jeanne M Schaefer | Pediatrics | 523 S Santa Fe Ave Ste B, Edmond, OK 73003-6291 | 2006-02-17 |
| 1851381057 | Timothy F Krous | Pediatrics | 2820 N Kelly, #100, Edmond, OK 73003 | 2005-10-27 |
| 1740270941 | Tammy Renee Maschino | Pediatrics | 2800 N Kelly Ave, Ste 200, Edmond, OK 73003-3008 | 2005-10-27 |
| 1831556612 | Kimberly Edgmon Md, Pllc | Pediatrics | 2820 N Kelly Ave, Suite 200, Edmond, OK 73003-3007 | 2016-01-25 |
| Find all providers in EDMOND | ||||
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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.