Tracey Wall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2454 Issued in CO

Practice address

785 Russell St
Craig, CO 81625-2019

Phone

(970) 826-2300

NPI assigned

Aug 14, 2007

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 CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rocky Mountain Clinics LLCGroup PAC ID 5597136218, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations (25 of 32)

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.

• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Fort Collins, CO
  • NPI 1295450294
  Medicare reassignment Care Compare group NPD (past)
• Rocky Mountain Clinics, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Alamosa, CO
  • NPI 1285468546
  NPD
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Northglenn, CO
  • NPI 1205552254
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Durango, CO
  • NPI 1245956143
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Pueblo, CO
  • NPI 1295451185
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Englewood, CO
  • NPI 1386360212
  NPD (past)
• Rocky Mountain Clinics LLC

  • Family Medicine Physician
  • Cortez, CO
  • NPI 1417651035
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Pueblo, CO
  • NPI 1417673021
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Wellington, CO
  • NPI 1477261154
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Golden, CO
  • NPI 1578289476
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Longmont, CO
  • NPI 1578289518
  NPD (past)
• Rocky Mountain Clinics LLC

  • Addiction Medicine (Family Medicine) Physician
  • Sterling, CO
  • NPI 1609584382
  NPD (past)

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1306038492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-826-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-826-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "TRACEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA-2454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elija Voyich, DDS
• Nastassja Voyich, DMD
• VVMC Diversified Services
• Walgreen Co
• Walgreen Co.
• Betty Jolene Walls, LPC
• Steven Paul Walls, LPC
• Walmart Inc.
• Spencer Wayman
• Wendy Nadolny, LCSW, LLC

• Physician Assistant in Craig, CO
• Providers in Craig, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.