Melissa S Wallace, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201393584LPN Issued in OR

Practice address

151 W 7TH Ave Ste 163
Eugene, OR 97401-2676

Phone

(541) 682-4464

NPI assigned

Jan 31, 2019

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

• Direct secure messaging: melissa.wallace.d1.p1@direct.lanecounty.nextgenshare.com

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.

• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  NPD (past)

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1972068278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 POLK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974051837",
            "telephone_number": "541-650-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W 7TH AVE STE 163",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012676",
            "telephone_number": "541-682-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MELISSA",
        "middle_name": "S",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201393584LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Wall
• Adam Wallace, EMT
• Diane Wallace, CADC II
• Kristi Wallace, FNP
• Leslie Michele Wallace, PT
• Michelle Lynn Wallace, LMT
• Sharon Renee Wallace
• Linda Walling, CERTIFIED DOULA
• Vanessa R Wallis
• Walmart Inc.

• Licensed Practical Nurse in Eugene, OR
• Providers in Eugene, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.