JD Wallace Enterprises

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JD WALLACE ENTERPRISES

Doing business as

Family Health Care Services

Practice address

4286 Memorial Dr Ste C
Suite B
Decatur, GA 30032-1221

Phone

(404) 499-0342

Fax

(678) 928-9427

NPI assigned

Jul 6, 2010

Last updated

Jul 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John David Wallace

Title

Ceo

Phone

(323) 558-2797

Specialties & licenses 2

Addresses

Other names 1

• Family Health Care Services Doing business as

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1346552478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43381",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "323-558-2797",
            "fax_number": "678-928-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4286 MEMORIAL DR STE C",
            "address_2": "SUITE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321221",
            "telephone_number": "404-499-0342",
            "fax_number": "678-928-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD WALLACE ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-558-2797"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anahita Javadpour, DMD
• Kshama Jawalekar, M.D.
• Jay C. Fisher DMD PC
• Bhanumathi Jayakumar, ANP-C
• Jayray Urodynamics LLC
• Jeannie Blom MD PC (Jeannie-In-A-Bottle)
• Charlene Andrea Jeanpierre, RN
• Jeavaat Medical LLC
• Jedidiah's Investment Holdings, Inc. (Jedidiah Transportation Services)
• Jeff a Traub, MD, PC

• Community/Behavioral Health Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.