Active NPI
Carol L. Wallace, OTR/L
- Occupational Therapist
- North Canton, OH
National Provider Identifier
1639348121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.001024
- Practice address
- 7235 Whipple Ave NW
North Canton, OH 44720-7137 - Phone
- (330) 498-8200
- NPI assigned
- Feb 28, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT.001024 | OH | Primary |
Addresses
Primary practice location
7235 Whipple Ave NW
North Canton, OH 44720-7137
Mailing address
2819 Grandview Blvd
Canfield, OH 44406-9123
Phone (330) 549-2141
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT.001024 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tudor Home Therapies Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1639348121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2819 GRANDVIEW BLVD",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069123",
"telephone_number": "330-549-2141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7235 WHIPPLE AVE NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447207137",
"telephone_number": "330-498-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "CAROL",
"middle_name": "L.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT.001024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.