NICOLE MARIE WALLACE PT
NPI 1609089028
Specialist in Virginia Beach, VA

Active since May 08, 2007Accepts Medicare Assignment
913 FIRST COLONIAL RD STE 204, VIRGINIA BEACH, VA 23454(757) 550-0725 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicole Marie Wallace Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE MARIE WALLACE PT (NPI 1609089028) is an individual specialist in Virginia Beach, Virginia and active in the NPI registry since May 2007. She is a graduate of Other (1998).

NPPES Registry Identity

NPI1609089028
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameNICOLE MARIE WALLACECredential: PT
Location Address913 FIRST COLONIAL RD STE 204Virginia Beach, VA 23454-3198
Mailing Address913 First Colonial Rd Ste 204Virginia Beach, VA 23454-3198 · (757) 550-0725
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateMay 8, 2007
Last NPPES UpdateMarch 18, 2019
NPI 1609089028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Also ListedGeneral Acute Care Hospital · ChildrenTaxonomy 282NC2000X · License 2305203070 (VA)
913 FIRST COLONIAL RD STE 204, Virginia Beach, VA 23454

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Nicole Marie Wallace Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012135304
PECOS Enrollment IDI20140828000778

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Developmental Therapist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Physical Therapist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Speech-Language Pathologist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Home Health
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Physical Therapist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Occupational Therapist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Social Worker (Clinical)
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454
Speech-Language Pathologist
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA 23454

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Wallace's NPI number?

The NPI number for Nicole Wallace is 1609089028. It was assigned to this individual provider in the NPPES registry on May 8, 2007.

Where is Nicole Wallace located?

Nicole Wallace practices at 913 First Colonial Rd Ste 204, Virginia Beach, VA 23454. The listed phone number is (757) 550-0725.

What is Nicole Wallace's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Nicole Wallace enrolled in Medicare?

Yes. Nicole Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nicole Wallace was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.