Active NPI
Wallace Optometry Associates
- Optometrist
- Bessemer, AL
National Provider Identifier
1245307032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- WALLACE OPTOMETRY ASSOCIATES
- Practice address
- 1431 2ND Ave N
Bessemer, AL 35020-5608 - Phone
- (205) 425-5182
- Fax
- (205) 426-5013
- NPI assigned
- Nov 29, 2006
- Last updated
- Apr 23, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fred Wallace, O.D.
- Title
- Partner
- Phone
- (205) 425-5182
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
1431 2ND Ave N
Bessemer, AL 35020-5608
Mailing address
1431 2ND Ave N
Bessemer, AL 35020-5608
Phone (205) 425-5182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060112000144 | AL | Part B Supplier - Clinic/Group Practice | 4688697998 | Practice locations: Bessemer, AL |
National Provider Directory
National Provider DirectoryLocations
1431 2nd Ave N
Bessemer, AL 35020
Phone (205) 425-5182
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Bessemer, AL
- NPI 1497850085
-
- Optometrist
- Birmingham, AL
- NPI 1164590659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240444800000",
"number": "1245307032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 2ND AVE N",
"city": "BESSEMER",
"state": "AL",
"postal_code": "350205608",
"telephone_number": "205-425-5182",
"fax_number": "205-426-5013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1431 2ND AVE N",
"city": "BESSEMER",
"state": "AL",
"postal_code": "350205608",
"telephone_number": "205-425-5182",
"fax_number": "205-426-5013"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALLACE OPTOMETRY ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-29",
"last_updated": "2009-04-23",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "FRED",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "205-425-5182",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bessemer, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.