Dauntrica Michele Wallstrum, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.020997 Issued in OH

Practice address

930 Bethesda Dr Ste 4
Zanesville, OH 43701-0815

Phone

(740) 569-5737

NPI assigned

Jul 13, 2017

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Ohio State University College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pbc.dauntricawallstrum@140098.advancedmd-direct.com
• FHIR API: https://api.qualifacts.org/api/fhir/midohiobh/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment Care Compare group NPD
• Alcove Ventures LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
  • NPI 1093191322
  Medicare reassignment NPD
• Mid-Ohio Behavioral Health LLC

  • Mental Health Counselor
  • Zanesville, OH
  • NPI 1578936746
  Medicare reassignment NPD

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1528580370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9046 LUPINE DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430686811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BETHESDA DR STE 4",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010815",
            "telephone_number": "740-569-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLSTRUM",
        "first_name": "DAUNTRICA",
        "middle_name": "MICHELE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.020997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara M Walker, LISW-S
• Brennen Wallace
• Tiffany Marie Wallace
• Carly M Wallis, M.S., RPA-C
• William Robert Christopher Wallis, OD
• Shannon Walters, CDCA
• Miranda Danielle Walton, MA, LPCC-S
• Alexis Y Wang, DDS
• April D Ward, LPN
• Jessica Nicole Ward, LPN

• Psychiatric/Mental Health Nurse Practitioner in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.