The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-15

Residential Treatment Facility, Intellectual and/or Developmental Disabilities Primary Specialty

NUCC Taxonomy Code: 320600000X

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Private Vehicle

NUCC Taxonomy Code: 347C00000X

An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 15, 2025

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

✅

NPI Profile Active July 29, 2025

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) July 29, 2025

Registered at 5715 SIGNAL POINTE DR APT 102, CINCINNATI, OH 452473285 (Tel: 5136860798)

📍

Business Mailing Address (Initial Record) July 29, 2025

Registered at 5715 SIGNAL POINTE DR APT 102, CINCINNATI, OH 452473285

👤

Provider Name / Credentials (Initial Record) July 29, 2025

Recorded as CHASEI WALLACE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2025

Private Vehicle

🟢

Initial NPI Registration & Enumeration July 29, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1861375677

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 29, 2025

Last Update: September 15, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

5715 Signal Pointe Dr Apt 102

Cincinnati, OH 452473285

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.