Kate E Wallis, MD, MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD455228 Issued in PA

Practice address

3401 Civic Center Blvd
Chca Emergency Med
Philadelphia, PA 19104-4319

Phone

(215) 590-1944

Fax

(215) 590-4454

NPI assigned

May 25, 2012

Last updated

Jan 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Childen's Health Care Associates Inc.

  dba CHCA Nurse Practitioners

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Children's Health Care Associates

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1851486807
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1023378965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "CHCA EMERGENCY MED",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHCA EMERGENCY MED",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1944",
            "fax_number": "215-590-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "KATE",
        "middle_name": "E",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD455228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaelyn Davis Waller, MSN, CPNP-AC, CHPPN
• Shakira Waller
• Genna Marie Wallerstein, OTR/L
• Kristi Ann Wallin, CRNA
• John M Wallis, MD
• June A Wallison, M.D.
• Aaron W Wallman-Stokes, M.D.
• Anna Walls, MD
• Jason David Walls, MD
• Kathleen Elizabeth Walls, PSY.D.

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.