Linda M. Wallace, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

388 Issued in MA

Practice address

1611 Cambridge St
Cambridge, MA 02138-4302

Phone

(617) 661-5525

NPI assigned

Jan 26, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1184694473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384302",
            "telephone_number": "617-661-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LINDA",
        "middle_name": "M.",
        "credential": "CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B501027",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PJ183",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014863",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5103053",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AD0161",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karin Maria Wall, LICSW
• Elizabeth Ainslie Wallace
• Jennifer L Wallace, RN
• Karen L. Wallace, MD
• Katherine Chandler Wallace, PMHCNS-BC
• Ryan J Wallace
• Rebecca Wallenstein
• Alexis Waller
• Edward Nicholas Waller, FNP-BC
• Courtney Constantine Walsh, PT, DPT

• Audiologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Audiologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.