Active NPI
Devyn Wallace
- Counselor
- Dayton, OH
National Provider Identifier
1134467897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C.1200675-TRNE
- Practice address
- 2745 S Smithville Rd
Dayton, OH 45420-2668 - Phone
- (937) 258-4245
- NPI assigned
- Jan 30, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C.1200675-TRNE | OH | Primary |
Addresses
Primary practice location
2745 S Smithville Rd
Dayton, OH 45420-2668
Mailing address
2745 S Smithville Rd
Dayton, OH 45420-2668
Phone (937) 258-4245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1200675-TRNE | OH | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Community | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Kettering, OH
- NPI 1003211061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359936000000",
"number": "1134467897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2745 S SMITHVILLE RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454202668",
"telephone_number": "937-258-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2745 S SMITHVILLE RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454202668",
"telephone_number": "937-258-4245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "DEVYN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-30",
"last_updated": "2013-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "C.1200675-TRNE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.