NPIMap

Organization Active NPI

Dr Tammy Wallace LLC

  • Optometrist
  • Ozark, AL
National Provider Identifier
1295118255
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-C02-TA-822 Issued in AL
Legal business name
DR TAMMY WALLACE LLC
Practice address
1234 Andrews Ave
Suite E
Ozark, AL 36360-3767
Phone
(334) 445-3937
Fax
(334) 445-3938
NPI assigned
Jul 8, 2015
Last updated
Jul 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Dr. Tammy Darlene Wallace, ODNPI 1134356645
Title
Owner
Phone
(334) 445-3937

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)CodeLicenseStatePrimary
Optometrist 152W00000X S-C02-TA-822 AL Primary

Addresses

Primary practice location

1234 Andrews Ave
Suite E
Ozark, AL 36360-3767

Mailing address

1234 Andrews Ave
Suite E
Ozark, AL 36360-3767
Phone (334) 445-3937

National Provider Directory

National Provider Directory

Locations

1234 Andrews Ave
Ste E
Ozark, AL 36360
Phone (334) 445-3937

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1295118255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 ANDREWS AVE",
            "address_2": "SUITE E",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603767",
            "telephone_number": "334-445-3937",
            "fax_number": "334-445-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 ANDREWS AVE",
            "address_2": "SUITE E",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603767",
            "telephone_number": "334-445-3937",
            "fax_number": "334-445-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TAMMY WALLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-445-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-C02-TA-822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozark, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.