Rebecca Ann Wallace, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1535 Newport Dr
Macedonia, OH 44056-1972

Phone

(216) 906-3164

NPI assigned

Jan 10, 2023

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 names 1

• Rebecca Ann Mravetz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwallace168888@ehrdirect.uhhospitals.org

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

• HQ of North Toledo LLC

  • Physical Therapist
  • Toledo, OH
  • NPI 1083343602
  NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1750095154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 NEWPORT DR",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440561972",
            "telephone_number": "216-906-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 NEWPORT DR",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440561972",
            "telephone_number": "216-906-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "MRAVETZ",
            "middle_name": "ANN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Voigt, BSN, RN, IBCLC
• Jessica Ann Von Benken, NP
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1927)
• Wal-Mart Stores East, LP (Vision Center 30-1927)
• Walgreen Co (Walgreens #07719)
• Michael Alan Willen, D.D.S.
• Carrie Yasenosky, BCBA, COBA, M.ED
• Sherry Hui Yu, M.D.
• Junpan Zhang, DMD
• Kathryn Ziegler, BCBA

• Occupational Therapist in Macedonia, OH
• Providers in Macedonia, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.