Wallace Tranum Jr.

Primary specialty

DriverTaxonomy code 172A00000X

License

T655898694600 Issued in FL

Practice address

415 Golden Arm Rd
Deltona, FL 32738-8653

Phone

(407) 460-7242

NPI assigned

Oct 26, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Non Emergency Transport LLC

  • Driver
  • Deltona, FL
  • NPI 1659915973
  NPD Authorized official

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

{
    "created_epoch": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572048000000",
    "number": "1265075865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 GOLDEN ARM RD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327388653",
            "telephone_number": "407-460-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 GOLDEN ARM RD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327388653",
            "telephone_number": "407-460-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANUM",
        "first_name": "WALLACE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-26",
        "last_updated": "2019-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "T655898694600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Deltona",
            "affiliation": "N",
            "address_1": "415 Golden Arm Rd",
            "city": "Deltona",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327388653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Toussaint, MSW, LCSW
• Robert Townsend, CC-P
• Mark Francis Tracey, PT
• Transcare USA
• Transformations Counseling, Inc
• Marla Mickel Trapp, MD
• Tri County Medical Associates PA
• Andrew Trombley
• Stephanie Ann Trout, APRN
• Tuba City Regional Health Care Center

• Driver in Deltona, FL
• Providers in Deltona, FL by specialty
• Driver in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2019; 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.