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Laurel Lynn Wallace

Peer Specialist β€’ Enterprise, OR

Active NPI 1881337319 Individual Practitioner Female Practitioner
Practice location in NPPES

606 Medical Pky
Enterprise, OR 97828

Call 5414264524 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

606 Medical Pky

Enterprise, OR 97828

Telephone 5414264524
Organization at the Same NPPES Address or Phone
Wallowa Valley Center For Wellness Facility NPI 1043249907

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2022

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: NPI first issued

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, β€œDoes 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

Compared with the same specialty in Enterprise and Oregon

10 active clinicians are listed under Peer Specialist with a practice address in Enterprise, OR (3,355 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

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

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-08-08
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Case Manager/Care Coordinator

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

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: Oregon Medical Board.
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
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2022

Peer Specialist

βœ…
NPI Profile Active April 13, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 13, 2022

Registered at 606 MEDICAL PKY, ENTERPRISE, OR 97828 (Tel: 5414264524)

πŸ“
Business Mailing Address (Initial Record) April 13, 2022

Registered at 405 NW 2ND ST, ENTERPRISE, OR 978281014 (Tel: 5413988671)

πŸ‘€
Provider Name / Credentials (Initial Record) April 13, 2022

Recorded as LAUREL WALLACE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 13, 2022

Case Manager/Care Coordinator

🟒
Initial NPI Registration & Enumeration April 13, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1881337319
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 13, 2022
Last Update: August 08, 2022
Sole Proprietor: Yes

Mailing Address

405 Nw 2nd St

Enterprise, OR 978281014

Phone: 5413988671

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.