Febe Iris Wallace, MEDICAL DOCTOR

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD23950 Issued in TN

Practice address

815 W 5TH North St
Morristown, TN 37814-3810

Phone

(423) 586-5032

Fax

(423) 581-8473

NPI assigned

Dec 23, 2005

Last updated

Sep 29, 2020By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cherokee Health Systems

  dba River Valley Health

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Internal Medicine

  Medicare reassignment NPD
• Cherokee Health Systems

  dba River Valley Health

  • Federally Qualified Health Center (FQHC)
  • White Pine, TN
  • NPI 1699666404
  NPD

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1811974512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W A J HWY",
            "address_2": "DEPARTMENT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "37877",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W 5TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143810",
            "telephone_number": "423-586-5032",
            "fax_number": "423-581-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "FEBE",
        "middle_name": "IRIS",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD23950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3889885",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "febe.wallace.p1@direct.cherokeehealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message Address",
            "address_1": "815 W 5th North St",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378143810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walgreen Co (Walgreens #11813)
• Walgreen Co (Rite Aid #19409)
• Walgreen Co (Walgreens #06788)
• David Arden Walker, M.D.
• Shannon Walker
• Deborah J Walters
• Katherine Eleanor Walton, PA-C
• Kellie G Ward, LPC-MHSP
• Rubi D Ward
• Vermica Ward

• Internal Medicine Physician in Morristown, TN
• Providers in Morristown, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.