Active NPI
Jennie Anesia Wallace, PHARMD
- Pharmacist
- Leeds, AL
National Provider Identifier
1427587690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13890
- Practice address
- 8551 Whitfield Ave
Leeds, AL 35094-7560 - Phone
- (205) 699-0677
- Fax
- (205) 699-0715
- NPI assigned
- Jun 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13890 | AL | Primary |
Addresses
Primary practice location
8551 Whitfield Ave
Leeds, AL 35094-7560
Mailing address
228 Windchase Dr
Birmingham, AL 35242-4640
Phone (205) 862-0022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13890 | AL | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496966400000",
"number": "1427587690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 WINDCHASE DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352424640",
"telephone_number": "205-862-0022",
"fax_number": "205-699-0715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8551 WHITFIELD AVE",
"city": "LEEDS",
"state": "AL",
"postal_code": "350947560",
"telephone_number": "205-699-0677",
"fax_number": "205-699-0715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "JENNIE",
"middle_name": "ANESIA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-09",
"last_updated": "2017-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "13890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leeds, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.