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Jackie Wallace, CRPA
NPI 1609751080 · Peer Specialist · Rochester, NY
Jackie Wallace, CRPA is a Peer Specialist provider in Rochester, NY (NPI 1609751080).
Provider details
- NPI number
- 1609751080
- Entity type
- Individual
- Primary specialty
- Peer SpecialistOther Service Providers
- Credential
- CRPA
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Profile Score
Basic profile(48/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2069 Hudson Ave.
D
Rochester, NY 14617
Phone: (585) 694-1307
Street-level locationGet directions
Mailing address
150 Mt.hope Ave
Rochester, NY 14620
Registry dates
- Enumerated
- 2025-08-06
- Last updated
- 2025-08-06
- Certified
- 2025-08-01
Frequently asked questions
- What is Jackie Wallace's NPI number?
- Jackie Wallace's National Provider Identifier (NPI) is 1609751080, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackie Wallace's specialty?
- Jackie Wallace is listed in the NPPES registry with a primary specialty of Peer Specialist (Other Service Providers).
- Where is Jackie Wallace located?
- Jackie Wallace's practice location on file with NPPES is 2069 Hudson Ave., Rochester, NY 14617.
- What is Jackie Wallace's phone number?
- The practice phone number listed in the NPPES registry for Jackie Wallace is (585) 694-1307.
- Is Jackie Wallace's NPI active?
- Yes — Jackie Wallace's NPI (1609751080) is active in the NPPES registry as of the last update on 2025-08-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.