Rachel Wallace, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013781 Issued in KY

Practice address

13802 Lake Point Cir Ste 102
Louisville, KY 40223-4219

Phone

(502) 245-4450

NPI assigned

Aug 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mays Surgical Associates PSC

  • Surgery Physician
  • Webster, TX
  • NPI 1679032338
  NPD

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1538717814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WASHBURN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224727",
            "telephone_number": "502-310-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13802 LAKE POINT CIR STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234219",
            "telephone_number": "502-245-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "RACHEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013781",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1148737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah I Wallace, M.D.
• Elizabeth Keller Wallace, MA, CFY-SLP
• Kali Wallace, APRN
• Kiara Learlene Wallace, MD
• Melissa Wallace
• Sandra Marie Wallace, PHARM.D.
• Sara Wallace, LPA
• Shermeka Wallace
• Stephanie P Wallace, APRN
• Whitney R Wallace, COTA

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.