Gregory Hall Wallace, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34008036W Issued in OH

Practice address

4623 Wesley Ave
BMF Pediatric Care Suite G
Norwood, OH 45212

Phone

(513) 631-3338

Fax

(513) 631-3385

NPI assigned

Jun 15, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Children's Hospital Medical Center

  dba Cincinnati Children's Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1346284957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640220",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452640220",
            "telephone_number": "513-281-8000",
            "fax_number": "513-281-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 WESLEY AVE",
            "address_2": "BMF PEDIATRIC CARE SUITE G",
            "city": "NORWOOD",
            "state": "OH",
            "postal_code": "45212",
            "telephone_number": "513-631-3338",
            "fax_number": "513-631-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "GREGORY",
        "middle_name": "HALL",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34008036W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2442986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew John Thomas, MD
• Trihealth Os, LLC (Trihealth Orthpaedic and Spine Institute)
• Victory Park Healthcare Group, Inc.
• Walgreen Co (Walgreens #07435)
• Eva Marie Walker
• Kent Allen Walpole Jr., PTA
• Kelly Diane Weber, LISW-S
• Ann W Wilson, PT

• Pediatrics Physician in Norwood, OH
• Providers in Norwood, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.