Wallace Optometry Associates

Primary specialty

OptometristTaxonomy code 152W00000X

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelleigh McVicker Buckingham, O.D.

  • Optometrist
  • Birmingham, AL
  • NPI 1164590659
  NPD (past)

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": []
}

• Walgreens
• Benjamin H. Walker II, M.D.
• Matalie Walker
• Charles Ray Wall, RPH
• William M Wall, MD
• Alana Wallace, PTA
• Fred Wallace, O.D.
• Amber Elaine Walls, CRNP
• Walmart Pharmacy 10 0764
• Philecia R Ward

• All providers in Bessemer, AL
• Optometrist in Alabama

• 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.

Verify at the official NPI Registry.