Rebecca Wallace SMTH, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2-067723 Issued in AL

Practice address

151 Hamilton LN
Calera, AL 35040-8700

Phone

(205) 668-4308

Fax

(205) 668-0894

NPI assigned

Jun 1, 2017

Last updated

Mar 17, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/centralalabamawellness/r4/

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.

• Mental Health Board of Chilton and Shelby Counties Inc

  dba Chilton-Shelby Mental Health Center

  • Community/Behavioral Health Agency
  • Clanton, AL
  • NPI 1487829966
  NPD (past)
• Mental Health Board of Chilton and Shelby Counties Inc

  dba Central Alabama Wellness

  • Community/Behavioral Health Agency
  • Calera, AL
  • NPI 1639247869
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1841728094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350400689",
            "telephone_number": "205-668-4308",
            "fax_number": "205-668-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 HAMILTON LN",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350408700",
            "telephone_number": "205-668-4308",
            "fax_number": "205-668-0894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Clanton",
            "state": "AL",
            "postal_code": "350452332",
            "country_code": "US",
            "telephone_number": "205-755-5933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 County Services Dr",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351246150",
            "country_code": "US",
            "telephone_number": "205-663-1252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMTH",
        "first_name": "REBECCA",
        "middle_name": "WALLACE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2-067723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Ficarra Simmons, RD, LD
• Mackenzie Sinkler, LICSW, MPA
• Thomas Samuel Slaughter III, D.C.
• Matthew Caleb Smith, PHARM.D
• Smithermans Phcy
• Vaneshia Venea Stallworth, RN
• Haley Stanford, CRNP
• Brandee Alane Stinson, LPC
• Nathan Julian Stuckey, MD
• Tiffany Taylor, MS,MSW,LMSW

• Licensed Practical Nurse in Calera, AL
• Providers in Calera, AL by specialty
• Licensed Practical Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.