Sarah Elizabeth Wallace
Physician Assistant (Medical)

Address: 21258 M 68 Hwy, Onaway, MI 49765-9692
Phone: 9897332082

Sarah Elizabeth Wallace (NPI# 1154792513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1154792513
Entity Type Individual
Full Name Sarah Elizabeth Wallace
Credential PA-C
Gender Female
Practice Address 21258 M 68 Hwy
Onaway
MI 49765-9692
Practice Telephone 9897332082
Mailing Address 21258 M 68 Hwy
Onaway
MI 49765-9692
Mailing Telephone 9897332082
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2015-10-12
Last Update Date 2016-05-19

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363AM0700X Physician Assistant · Medical Physician Assistants & Advanced Practice Nursing Providers 5601007440 MI

Providers with the same name

NPI Name Taxonomy Address Enumeration
1851862270 Sarah Jane Wallace Nurse Practitioner Saint John Urgent Care, 3550 S 4th St, Ste B, Leavenworth, KS 66048 2018-12-11
1164733762 Sarah Ade Wallace Dentist 7017 John Deere Parkway - Suite 2b, Moline, IL 61265 2010-06-29
1760709745 Sarah Elizabeth Wallace Speech-Language Pathologist 711 Forbes Avenue, 406 Fisher Hall, Pittsburgh, PA 15282 2010-04-29
1376011510 Sarah Wallace Social Worker 1635 Union Center Maine Hwy Ste 204, Endicott, NY 13760-1340 2018-11-06
1912451196 Sarah Wallace Audiologist 1528 Common St Ste 5, New Braunfels, TX 78130-3336 2016-08-05
1396114856 Sarah Wallace Pharmacist 2780 Wilma Rudolph Blvd, Clarksville, TN 37040-5897 2015-09-15
1568850006 Sarah Wallace Nurse Practitioner 390 Limit St, Leavenworth, KS 66048-4525 2015-01-07
1912330440 Sarah M Wallace Case Manager/Care Coordinator 4253 N Crossover Rd, Fayetteville, AR 72703-4593 2013-08-20
1457660508 Sarah Wallace Registered Nurse 1125 Pierce St, Sioux City, IA 51105-1485 2010-10-06
1144458969 Sarah J Wallace Emergency Medicine 100 Michigan St Ne, Grand Rapids, MI 49503-2560 2009-07-01
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Physician Overview

NPI 1154792513
PAC ID by PECOS 4082912423
Professional Enrollment ID I20160418002001
Full Name Sarah E Wallace
Organization Legal Name THUNDER BAY COMMUNITY HEALTH SERVICE INC
Phone Number 9897854855
Gender F
Graduation Year 2015
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 0143296772
Number of Group Practice Members 28
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
230105 MCLAREN NORTHERN MICHIGAN
230036 MIDMICHIGAN MEDICAL CENTER - ALPENA

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1386248763 Haley Durrant Physician Assistant 1740 N Telegraph Rd, Dearborn, MI 48128-1271 2020-11-25
1023616687 Alexandria Jaclyn Miller Physician Assistant 4700 Chipman Dr, Waterford, MI 48327-3413 2020-10-15
1639777287 Piotr Z Purzycki Physician Assistant 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 2020-10-15
1013524859 Amber Lee Physician Assistant 2265 South Lindenroad, Suite A, Flint, MI 48532 2020-09-25
1982212072 Alexandria Bower-nelson Physician Assistant 1302 Porter Drive, Charlotte, MI 48813 2020-07-15
1013535343 Maria Pavia Physician Assistant 41302 Scarborough Ln, Novi, MI 48375-2893 2020-07-13
1073130241 Kelly F Esper Physician Assistant 9043 Glenwood Ln, Northville, MI 48168-9129 2020-07-02
1811513971 Tasha Baker Physician Assistant 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 2020-06-24
1437770054 Sterling Ryan Maxfield Physician Assistant 6187 Oak Grove Rd, Howell, MI 48855-8247 2020-05-05
1760018808 Rachel Renee Mackmin Physician Assistant 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 2020-03-20
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Office Location

Street Address 21258 M 68 HWY
City ONAWAY
State MI
Zip Code 49765-9692

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447259783 Walter Jacquemin Emergency Medicine 21258 M 68 Hwy, Onaway, MI 49765-9692 2005-07-19
1821536269 Heidi Wilson Dental Hygienist 21258 M 68 Hwy, Onaway, MI 49765-9692 2017-02-06
1174079636 Holly Ehrke Nurse Practitioner 21258 M 68 Hwy, Onaway, MI 49765-9692 2016-08-25
1588031314 Joshua Wyeth Physician Assistant 21258 M 68 Hwy, Onaway, MI 49765-9692 2015-08-27
1770912776 Maureen Mitchell Nurse Practitioner 21258 M 68 Hwy, Onaway, MI 49765-9692 2013-11-11
1386871101 Thunder Bay Community Health Service, Inc. Pharmacy 21258 M 68 Hwy, Onaway, MI 49765-9692 2009-06-19
1669571444 Elaine C Smith Family Medicine 21258 M 68 Hwy, Onaway, MI 49765-9692 2006-09-21
1508804246 Thunder Bay Community Health Service, Inc Clinic/Center 21258 M 68 Hwy, Onaway, MI 49765-9692 2006-06-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689777237 Onaway Area Ambulance Service Ambulance 20734 Industrial Park, Onaway, MI 49765 2006-09-07
1891740379 Theodore K Reahm Family Medicine 3570 1/2 N Veterens Drive, Onaway, MI 49765 2006-05-23
1316916083 Gary E Willey Chiropractor 102 S Veterans Drive, Onaway, MI 49765 2006-03-16
1710371877 Cori Williams Nurse Practitioner 21258 W M 68 Hwy, Onaway, MI 49765 2015-03-26
1477884831 Thunder Bay Community Health Service, Inc. Clinic/Center 4549 M 33, Onaway, MI 49765 2010-01-26
1164627709 Onaway Chiropractic Center PC Chiropractor 20417 E State St, Onaway, MI 49765 2007-06-15
1427040898 Douglas A Olree Chiropractor 20417 E State St, Box 74, Onaway, MI 49765-0074 2005-08-22
1093720823 Great Lakes Medical Care Inc Pharmacy 20724 State St, Onaway, MI 49765-0100 2006-07-30
1609004951 Leah H Arnold Social Worker 4549 M 33, Onaway, MI 49765-0307 2009-06-25
1952571192 Douglas A.s. King Family Medicine 21258 W M 68 Hwy, Onaway, MI 49765-0722 2008-03-04
Find all providers in zip 49765

Competitor

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City ONAWAY
Zip Code 49765

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.