Brandi Wallace, HAIR LOSS SPECIALIST

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

418829 Issued in MD

Practice address

235 W Main St Ste E
Salisbury, MD 21801-4868

Phone

(443) 447-2028

NPI assigned

Nov 30, 2021

Last updated

Dec 31, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• The Hair Clinic RX, LLC

  • Durable Medical Equipment & Medical Supplies
  • Salisbury, MD
  • NPI 1043907413

  Prosthetics Case Management

  NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1457019135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S SCHUMAKER DR APT 1D",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218049289",
            "telephone_number": "443-447-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W MAIN ST STE E",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014868",
            "telephone_number": "443-447-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BRANDI",
        "name_prefix": "Mrs.",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MD",
            "license": "418829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co. (Walgreens #9927)
• Walgreen Co. (Walgreens #12130)
• David T Walker, MD
• Mary Anne Walker, CRNP
• Stacey Renee Walker, LGSW
• Karen Ashley Walls, LMSW
• Amy D Walsh, M.D.
• Mark David Walsh, M.D.
• Walter C Schaefer MD PA
• Jessica Marie Walter, PHD, ATC

• Prosthetics Case Management in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; 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.