Catherine Lauren Wallace, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

218000 Issued in NC

Practice address

930 3Rd St
Greensboro, NC 27405-6967

Phone

(336) 890-3200

Fax

(336) 890-3290

NPI assigned

Mar 29, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wake Forest Baptist Health Care at Home, LLC Home health agency, Wilkesboro, NC, CCN 347043
• North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
• Wilkes Regional Medical Center Hospital, North Wilkesboro, NC, CCN 340064

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwallace2754934@carolinashealthcaresystem.direct-ci.com

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• County of Wilkes

  dba Wilkes County DSS

  • State or Local Public Health Clinic/Center
  • Wilkesboro, NC
  • NPI 1962565788
  Medicare reassignment NPD
• Moses Cone Medical Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1427095249

  Family Medicine

  Medicare reassignment NPD
• Moses Cone Physician Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1093953127

  Family Medicine

  Medicare reassignment NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  Family Medicine

  Medicare reassignment NPD
• Moses Cone Medical Services, Inc.

  dba Western Rockingham Family Medicine

  • Family Medicine Physician
  • Madison, NC
  • NPI 1629376363
  NPD
• Moses Cone Physician Services Inc

  dba Triad Hospitalists

  • Hospitalist Physician
  • Greensboro, NC
  • NPI 1326363383
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Carolina Baptist Hospital

  • Psychiatric Hospital Unit
  • Winston Salem, NC
  • NPI 1063480531
  Care Compare affiliation
• North Carolina Baptist Hospital

  • Rehabilitation Hospital Unit
  • Winston Salem, NC
  • NPI 1114995677
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1144211301
  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Wake Forest Baptist Medical Center

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1609162098

  Hospital

  Care Compare affiliation
• North Carolina Baptist Hospital

  dba Winston East Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Winston Salem, NC
  • NPI 1912179219

  Hospital

  Care Compare affiliation
• Wake Forest Baptist Health Care at Home, LLC

  dba Atrium Health Wake Forest Baptist - Care at Home

  • Home Health Agency
  • Wilkesboro, NC
  • NPI 1487075149
  Care Compare affiliation
• WRMC Hospital Operating Corporation

  dba Wilkes Regional Medical Center

  • General Acute Care Hospital
  • North Wilkesboro, NC
  • NPI 1881614071
  Care Compare affiliation

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1497118335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 3RD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056967",
            "telephone_number": "336-890-3200",
            "fax_number": "336-890-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N Church St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011007",
            "country_code": "US",
            "telephone_number": "336-832-8035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CATHERINE",
        "middle_name": "LAUREN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "218000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwallace305634@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Diect Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "930 3rd St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274056967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Jo Wall, LCAS-A
• Konette Kendall Wall, CRNA
• Martha Elizabeth Wall, ATC
• Ryshee Wall, LCSWA
• Thomas Craven Wall, M.D.
• Celeste Nicole Wallace, D.O.
• Erica Renee Wallace, D.O.
• Imani Wallace
• Sophia Pina Wallace
• Stephanie Dawn Wallace, SW

• Family Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.