Angela B. Wallenbrock, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35049858 Issued in OH

Legal business name

ANGELA B. WALLENBROCK, MD

Practice address

880 Greenlawn Ave
Columbus, OH 43223-2616

Phone

(614) 449-9664

Fax

(614) 444-5839

NPI assigned

Jul 17, 2013

Organization subpart

No

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

Authorized official

Name

Angela B Wallenbrock, MD

Title

Owner

Phone

(614) 432-6410

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1417398587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182255",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432182255",
            "telephone_number": "614-430-5707",
            "fax_number": "614-430-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 GREENLAWN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232616",
            "telephone_number": "614-449-9664",
            "fax_number": "614-444-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA B. WALLENBROCK, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "WALLENBROCK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-432-6410",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35049858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.