Blake Wallace
NPI 1821617663ActiveIndividual· Occupational Therapy Assistant· Germantown, TN
Occupational Therapy Assistant in Germantown, Tennessee, licensed in MS, with an NPI issued in April 2020.
Overview
| NPI | 1821617663 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 12, 2020 |
| Last updated in NPPES | Apr 12, 2020 |
| Certified by provider | Apr 12, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapy Assistant Primary | 224Z00000X | TA3704 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Occupational Therapy Assistant providers in Germantown
- 1720627813
- 1457075327
- 1487053609
- 1821681784
- 1487349437
- 1174156335
- 1194650895
- 1538643556
- 1356992002
- 1225276538
- 1386395424