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MR. JAMES LEWIS WALLACE CPO NPI 1396891933


NPI Information

NPI: 1396891933
Provider Name: MR. JAMES LEWIS WALLACE, CPO
Classification: Orthotist - 222Z00000X
Entity Type: Individual
Address:
1901 BRUNSWICK AVE
SUITE 200
CHARLOTTE, NC
ZIP 28207
Phone: (704) 348-4488
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MR. James Lewis Wallace, CPO is an orthotist in Charlotte, NC. The provider is a health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. MR. James Lewis Wallace, CPO NPI is 1396891933. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1901 BRUNSWICK AVE
SUITE 200
CHARLOTTE, NC
ZIP 28207-809
Phone: (704) 348-4488
Fax: (704) 348-4496

The enumeration date for this NPI number is 1/26/2007 and was last updated on 7/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1224P00000XProsthetistNo
2222Z00000XOrthotistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17795261MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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