Active NPI
Ian T Walloch
- Behavior Analyst
- Virginia Beach, VA
National Provider Identifier
1659834992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332 - Phone
- (224) 206-5001
- NPI assigned
- Apr 12, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332
Mailing address
780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332
Phone (224) 206-5001
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642377600000",
"number": "1659834992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 LYNNHAVEN PKWY STE 400",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234527332",
"telephone_number": "224-206-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 LYNNHAVEN PKWY STE 400",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234527332",
"telephone_number": "224-206-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLOCH",
"first_name": "IAN",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-12",
"last_updated": "2022-01-17",
"certification_date": "2022-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.