Julie Schroeder Wallace, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

823 Issued in OK

Practice address

4334 NW Expressway
Suite 102
Oklahoma City, OK 73116-1515

Phone

(405) 740-8800

Fax

(405) 657-2556

NPI assigned

Sep 11, 2012

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

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1255681839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NW 193RD CIR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730123553",
            "telephone_number": "405-740-8800",
            "fax_number": "405-657-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 NW EXPRESSWAY",
            "address_2": "SUITE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161515",
            "telephone_number": "405-740-8800",
            "fax_number": "405-657-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JULIE",
        "middle_name": "SCHROEDER",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace B. McLeod III, Inc
• Wallace Foot and Ankle Center, PLLC
• Alexis Wallace
• Bailey Layne Wallace
• Johnna Wallace, AUD
• Keshawn Wallace, LPC-ASSOCIATE
• Kirsten Ann Wallace, PT
• Leslie Dawn Wallace
• Mark Wallace
• Marzette Wallace

• Psychologist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.