Anthony Nelson Wallace Jr.

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

9001 Arbor St Ste 206
Omaha, NE 68124-2066

Phone

(531) 772-9325

NPI assigned

Apr 21, 2025

Sex

Male

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": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1780471102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 S 42ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052910",
            "telephone_number": "531-772-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 ARBOR ST STE 206",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242066",
            "telephone_number": "531-772-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANTHONY",
        "middle_name": "NELSON",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Walker Jr.
• Emily Wall, M.S.,CCC-SLP
• Heather A Wall, LIMHP, LMHP, LADC
• Justine Alexandra Wall, M.S.
• Amanda Wallace
• Beionka Wallace
• Brenda Wallace
• Dala Wallace
• David Mark Wallace
• Deion Wallace

• Personal Care Attendant in Omaha, NE
• Providers in Omaha, NE by specialty
• Personal Care Attendant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.