NPIMap

Organization Active NPI

Wallace Foot and Ankle Center, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Oklahoma City, OK
National Provider Identifier
1336571785
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
292 Issued in OK
Legal business name
WALLACE FOOT AND ANKLE CENTER, PLLC
Practice address
608 NW 9TH St
Suite 4210
Oklahoma City, OK 73102-1068
Phone
(405) 446-8290
NPI assigned
Aug 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Dr. Trenton Dale Wallace, DPMNPI 1861633539
Title
Podiatrist
Phone
(405) 446-8290

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 292 OK Primary

Addresses

Primary practice location

608 NW 9TH St
Suite 4210
Oklahoma City, OK 73102-1068

Mailing address

608 NW 9TH St
Suite 4210
Oklahoma City, OK 73102-1068
Phone (405) 446-8290

National Provider Directory

National Provider Directory

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": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1336571785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 NW 9TH ST",
            "address_2": "SUITE 4210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021068",
            "telephone_number": "405-446-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 NW 9TH ST",
            "address_2": "SUITE 4210",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021068",
            "telephone_number": "405-446-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE FOOT AND ANKLE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TRENTON",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "405-446-8290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.