Active NPI
Patricia M Wallace, A.P.
- Acupuncturist
- Neptune Beach, FL
National Provider Identifier
1174771281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AP1523
- Practice address
- 217 1St St
Neptune Beach, FL 32266-6145 - Phone
- (904) 962-4742
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AP1523 | FL | Primary |
Addresses
Primary practice location
217 1St St
Neptune Beach, FL 32266-6145
Mailing address
1015 Atlantic Blvd
Suite 123
Atlantic Beach, FL 32233-3313
Phone (904) 962-4742
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 |
|---|---|---|---|
| AP1523 | FL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235865600000",
"number": "1174771281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 ATLANTIC BLVD",
"address_2": "SUITE 123",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "322333313",
"telephone_number": "904-962-4742",
"fax_number": "904-962-4742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 1ST ST",
"city": "NEPTUNE BEACH",
"state": "FL",
"postal_code": "322666145",
"telephone_number": "904-962-4742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "PATRICIA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "A.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-03",
"last_updated": "2009-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "AP1523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neptune Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.