Active NPI
Aja Wallace
- Social Worker
- Lake City, SC
National Provider Identifier
1346699576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 215 Maple Dr
Lake City, SC 29560-3931 - Phone
- (843) 939-1363
- NPI assigned
- Jun 8, 2016
- Last updated
- Jun 8, 2016
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
215 Maple Dr
Lake City, SC 29560-3931
Mailing address
215 Maple Dr
Lake City, SC 29560-3931
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1346699576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 MAPLE DR",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295603931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 MAPLE DR",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295603931",
"telephone_number": "843-939-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "AJA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-08",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, SC
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0621)
- Wal-Mart Stores East LP (Vision Center 30-0621)
- Wall Home Medical Equipment, Inc
- Wall Home Medical Equipment, Inc.
- Wallace Chiropractic and Spinal Rehab, LLC
- Tyrone D Wallace, DC
- Cheryl K Walter, RPT
- Lavelle Weaver, RN
- Whitney Deanna Weber, OD
- Tanya Webster, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.