Jessica S Wallace

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.130912 Issued in IL

Practice address

8130 Baymeadows Way W Ste 201a
Jacksonville, FL 32256-7451

Phone

(904) 503-9442

NPI assigned

Oct 23, 2026

Last updated

Oct 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Illumia Health LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jacksonville, FL
  • NPI 1972341147
  NPD (past)
• Illumia Health LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • White Bear Lake, MN
  • NPI 1972316289
  NPD (past)

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

{
    "created_epoch": "1792713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1376440172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8875 GRASSY BLUFF DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164711",
            "telephone_number": "954-913-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 BAYMEADOWS WAY W STE 201A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567451",
            "telephone_number": "904-503-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JESSICA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-23",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.130912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley A Wallace, MD
• Dustin L Wallace, CPHT
• Elizabeth Roslyn Wallace, PHD
• Francheska Wallace, HOME HEALTH AIDE
• Ima Latoya Wallace
• Joyce Wallace, CRNA, ARNP
• Kristen Paula Wallace, PA
• Leigh M Wallace, DDS
• Linda Wallace, MSW
• Lisa Wallace

• Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; 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.