Romita L Wallen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23719 Issued in SC

Practice address

2736 Rush Haven Dr
Mt Pleasant, SC 29466-8578

Phone

(843) 881-7477

Fax

(843) 881-7477

NPI assigned

Nov 4, 2005

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Covenant Counseling of South Carolina

  • Professional Counselor
  • Summerville, SC
  • NPI 1073732822
  NPD (past)
• Synergy Counseling Services LLC

  • Professional Counselor
  • Summerville, SC
  • NPI 1801838552

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1356332563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 RUSH HAVEN DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668578",
            "telephone_number": "843-881-7477",
            "fax_number": "843-881-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 RUSH HAVEN DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668578",
            "telephone_number": "843-881-7477",
            "fax_number": "843-881-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "ROMITA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "23719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237194",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #07156)
• Walgreen Co (Walgreens #15442)
• Stephanie Eileen Wall, RDH, MSDH, MED, OM
• Kelsey Marie Wallace, OTD
• Lacie Victoria Wallace, MD
• Emily Kathryn Waller, DNP, CNM, WHNP
• Catherine Anne Walsh, PH.D.
• Courtney Josephine Walsh, PA
• Deanna Sink Walter, LPC-A
• Jessica F. Walters, MS, PT

• Family Medicine Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.