Johnna Wallace, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

4140 Issued in OK

Practice address

11500 N Portland Ave
Oklahoma City, OK 73120

Phone

(405) 548-4300

Fax

(405) 548-4350

NPI assigned

Nov 22, 2013

Last updated

Feb 28, 2025By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hearts for Hearing FoundationGroup PAC ID 8820195399, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnna.wallace.1@30629.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hearts for Hearing Foundation

  • Hearing and Speech Clinic/Center
  • Oklahoma City, OK
  • NPI 1215006150

  Audiologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1740610005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204625",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8125 E 101st St Ste 50",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741337245",
            "country_code": "US",
            "telephone_number": "918-392-7600",
            "fax_number": "405-548-4350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2272 36th Ave NW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730723251",
            "country_code": "US",
            "telephone_number": "405-767-4200",
            "fax_number": "405-548-4350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOHNNA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "4140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wallace B McLeod III, Inc
• Wallace B. McLeod III, Inc
• Wallace Foot and Ankle Center, PLLC
• Alexis Wallace
• Bailey Layne Wallace
• Julie Schroeder Wallace, PH.D
• Keshawn Wallace, LPC-ASSOCIATE
• Kirsten Ann Wallace, PT
• Leslie Dawn Wallace
• Mark Wallace

• Audiologist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Audiologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.