Angela B Wallenbrock, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35049858W Issued in OH

Practice address

1570 Heatherwae Loop
Powell, OH 43065-9363

Phone

(614) 432-6410

NPI assigned

Jan 23, 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 1

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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 and National Provider Directory roles.

• Holistic Wellness Solutions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
  • NPI 1063932119
  Medicare reassignment NPD
• Holistic Wellness Solutions LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1588261929
  NPD
• Consolidated Care Inc

  • Mental Health Counselor
  • West Liberty, OH
  • NPI 1215933569
  NPD (past)
• Ohio Hospital for Psychiatry, LLC

  • Psychiatric Hospital
  • Columbus, OH
  • NPI 1821186271
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1215907332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 HEATHERWAE LOOP",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659363",
            "telephone_number": "614-432-6410",
            "fax_number": "614-430-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 HEATHERWAE LOOP",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659363",
            "telephone_number": "614-432-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENBROCK",
        "first_name": "ANGELA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35049858W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0599320",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Waldren, LISW
• Walgreen Co
• Walgreen Co
• Jessica Walker
• Madison Wallace
• Janis Lou Walters, RN
• Deanna Dawn Walti, RN, FNP-BC
• Songping Wan
• Ye Wang, PHARMD
• Morgan Wareham, D.C.

• Psychiatry Physician in Powell, OH
• Providers in Powell, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.