Walltown Community Outreach, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

WALLTOWN COMMUNITY OUTREACH, INC.

Practice address

1119 Clarendon St
Durham, NC 27705-3511

Phone

(919) 425-5436

NPI assigned

Aug 27, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Waldo Nathan Fenner

Title

Chief Executive Officer

Phone

(919) 425-5436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1659504488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WEST BLUB BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053511",
            "telephone_number": "919-425-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 CLARENDON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053511",
            "telephone_number": "919-425-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLTOWN COMMUNITY OUTREACH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "FENNER",
        "authorized_official_first_name": "WALDO",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-425-5436",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Russell Wallace, DO
• Todd A Wallace, PA-C
• Stacey Greanias Wallen, CGC
• Ethan Waller, RD, LDN
• Jesscia Wallis
• David Walmer
• Walnut Vision Care NC
• Chaille Anne Walsh, PH.D.
• Chelsea Jean Walsh, CPNP-PC
• Conor Walsh, MD

• Case Management Agency in Durham, NC
• Providers in Durham, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.