William Lucian Wallace III

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

138 Mayflower LN
Sandstone, WV 25985-9278

Phone

(304) 575-9256

NPI assigned

Jul 26, 2022

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1689300485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MAYFLOWER LN",
            "city": "SANDSTONE",
            "state": "WV",
            "postal_code": "259859278",
            "telephone_number": "304-575-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MAYFLOWER LN",
            "city": "SANDSTONE",
            "state": "WV",
            "postal_code": "259859278",
            "telephone_number": "304-575-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "LUCIAN",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Rose Lilly-Morgan
• Melissa Ann McCloud
• Bethany O'Bryan
• Ashley A Roop
• Danny Wayne Vandall
• Jessica Joy Ward

• Personal Care Attendant in Sandstone, WV
• Providers in Sandstone, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.

Verify at the official NPI Registry.