Meghan Wallace, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

DR.0075789 Issued in CO

Practice address

12631 E 17TH Ave Ste F496
Aurora, CO 80045-2527

Phone

(720) 553-2696

NPI assigned

May 2, 2022

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Denver Health and Hospital Authority

  dba Wellington E. Webb Center for Primary Care

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1922049014
  NPD (past)

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1477298776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE STE F496",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE STE F496",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527",
            "telephone_number": "720-553-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MEGHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0075789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmelle Wallace, MD
• Christine McKenney Wallace, OTR
• Elizabeth Brezinski Wallace, MD
• Jeffrey Wallace, MD
• Kayla Wallace
• Nichole G Wallace, MD
• Rachel Wallace
• Rachel Schwartz Wallach, PA-C
• Diana Joan Walleigh, MD
• Brett Wallen, DMD

• General Practice Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.