Active NPI
Heather Wallace, RN
- Registered Nurse
- Woonsocket, RI
National Provider Identifier
1295027274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN49156
- Practice address
- 55 Cummings Way
Woonsocket, RI 02895-3247 - Phone
- (401) 235-7000
- NPI assigned
- May 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN49156 | RI | Primary |
Addresses
Primary practice location
55 Cummings Way
Woonsocket, RI 02895-3247
Mailing address
55 Cummings Way
Woonsocket, RI 02895-3247
Phone (401) 235-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN49156 | RI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Alliance | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Woonsocket, RI
- NPI 1013288083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1295027274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 CUMMINGS WAY",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028953247",
"telephone_number": "401-235-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 CUMMINGS WAY",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028953247",
"telephone_number": "401-235-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "HEATHER",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-09",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "RI",
"license": "RN49156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woonsocket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.