Amy Catherine Wallace, O.T.

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

Practice address

2920 Ronald Reagan Blvd
Ste 110
Cumming, GA 30041

Phone

(770) 889-0885

Fax

(770) 880-0886

NPI assigned

Jan 17, 2007

Last updated

Dec 13, 2013By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• North Georgia Hand Therapy, LLC

  • Hand Occupational Therapist
  • Cumming, GA
  • NPI 1326396136
  Authorized official Same address or phone
• Johns Creek Physical Therapy

  • Physical Therapist
  • Suwanee, GA
  • NPI 1891890844
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1376695627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 RONALD REAGAN BLVD",
            "address_2": "STE 110",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-889-0885",
            "fax_number": "770-880-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 RONALD REAGAN BLVD",
            "address_2": "STE 110",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-889-0885",
            "fax_number": "770-880-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "AMY",
        "middle_name": "CATHERINE",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004063",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899040116A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1376695627",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NUMBER",
            "identifier": "611446156001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colby Walker, PTA
• Dylan Robert Walker, DMD
• Justin Lee Walker, LMT
• Shaylyn Walker
• Walkers Unrivaled Surgical Services
• Jennifer Wallace, MS, LPC, RPT
• Oscar Russell Wallace
• Sara W Wallace, NP-C
• Michael Lee Waller, MD
• Suzanne Waller, L.P.C.

• Hand Occupational Therapist in Cumming, GA
• Providers in Cumming, GA by specialty
• Hand Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.