Rebecca Jane Wallig, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO2024-0091 Issued in NM

Practice address

1010 Spruce St
Espanola, NM 87532-2724

Phone

(505) 367-0340

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwallig255024@direct.phs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354

  Pediatrics

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Presbyterian Healthcare Services

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1033791892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "505-367-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIG",
        "first_name": "REBECCA",
        "middle_name": "JANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "DO2024-0091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Wagner, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Valerie Lynn Wall, FNP-C
• Michael Wayne Wallington, LPCC
• Gary A Ward, LMT
• Scarlette Allyn Waterman, BA, LSAA
• Stacie F Waters
• Terry Waters, CNP

• Pediatrics Physician in Espanola, NM
• Providers in Espanola, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.