Carol Lynn Gates Walling, M.ED, , COMS

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

857266 Issued in IL

Practice address

1109 Plymouth Dr Apt B
Champaign, IL 61821-6567

Phone

(717) 420-0145

NPI assigned

Aug 2, 2010

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

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1386958379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 PLYMOUTH DR APT B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618216567",
            "telephone_number": "717-420-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 PLYMOUTH DR APT B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618216567",
            "telephone_number": "717-420-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLING",
        "first_name": "CAROL",
        "middle_name": "LYNN GATES",
        "name_prefix": "Ms.",
        "credential": "M.ED, , COMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "IL",
            "license": "857266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edward Wallace Jr., PA-C
• Kanisha Wallace
• Douglas M Wallen
• Shawna Marie Waller, LCPC
• Taylor Waller
• Taylor Wallis, LSW
• Walmart Inc.
• Marie Neel Walser
• Deborah Lynn Walsh, APN
• Harlie Renee Walters

• Local Education Agency (LEA) in Champaign, IL
• Providers in Champaign, IL by specialty
• Local Education Agency (LEA) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.