Active NPI
Katelin Marie Wallace
- Homemaker
- South Bloomfield, OH
National Provider Identifier
1740040435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 5408 Morning Glory St
South Bloomfield, OH 43103-3518 - Phone
- (434) 365-9020
- NPI assigned
- Mar 20, 2024
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | OH | Primary |
Addresses
Primary practice location
5408 Morning Glory St
South Bloomfield, OH 43103-3518
Mailing address
5408 Morning Glory St
South Bloomfield, OH 43103-3518
Phone (614) 489-8162
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": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1740040435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5408 MORNING GLORY ST",
"city": "SOUTH BLOOMFIELD",
"state": "OH",
"postal_code": "431033518",
"telephone_number": "614-489-8162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5408 MORNING GLORY ST",
"city": "SOUTH BLOOMFIELD",
"state": "OH",
"postal_code": "431033518",
"telephone_number": "434-365-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "KATELIN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-20",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bloomfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.