Lura Wallace, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-3362 Issued in NM

Practice address

1990E Lohman Ave 204
Las Cruces, NM 88001-3172

Phone

(575) 525-0304

Fax

(575) 524-4813

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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 NM

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1629141635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300G EL PASEO RD 201",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880016024",
            "telephone_number": "575-525-0304",
            "fax_number": "575-524-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990E LOHMAN AVE 204",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013172",
            "telephone_number": "575-525-0304",
            "fax_number": "575-524-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LURA",
        "name_prefix": "Miss",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-3362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger W. Walker
• Sarah Lynn Walker
• Shannon A Walker, MS
• Adam Leo Wallace
• John Wallace, CRNA
• Michael Jon Wallace, CPSW
• Makayla Wallender
• Michelle Waller, RBT
• Wendi Cheree Wallin, DC
• Wallis Enterprises Inc

• Clinical Social Worker in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.