Erica Renee Wallace, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2012-00866 Issued in NC

Practice address

4023 Guilford College Rd
Greensboro, NC 27407-8052

Phone

(336) 890-2040

Fax

(336) 890-2099

NPI assigned

May 15, 2009

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

Other identifiers 2

Electronic endpoints 2

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 Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

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 and National Provider Directory roles.

• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982
  Medicare reassignment Care Compare group NPD
• Moses Cone Medical Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1427095249

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Moses Cone Physician Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1093953127

  Family Medicine

  Medicare reassignment NPD
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1720794944
  NPD
• Eagle Physicians and Associates PA

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD
• Moses Cone Medical Services, Inc.

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

  • Hospitalist Physician
  • Greensboro, NC
  • NPI 1326363383
  NPD
• Moses Cone Physician Services, Inc.

  • Orthopaedic Surgery Physician
  • Greensboro, NC
  • NPI 1427680768
  NPD
• Eagle Physicians and Associates PA

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1396852570
  NPD (past)
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1407871361
  NPD (past)
• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648
  NPD (past)

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1528293883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 GUILFORD COLLEGE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274078052",
            "telephone_number": "336-890-2040",
            "fax_number": "336-890-2099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Huffman Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272158700",
            "country_code": "US",
            "telephone_number": "336-538-1234 x3530",
            "fax_number": "336-538-2390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Pomona Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274071616",
            "country_code": "US",
            "telephone_number": "336-268-4100",
            "fax_number": "336-268-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERICA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2012-00866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC7155A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920661",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Erica.Wallace@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5921 W Friendly Ave Ste D",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274103268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Erica.Wallace@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "104 Pomona Dr",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274071616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martha Elizabeth Wall, ATC
• Ryshee Wall, LCSWA
• Thomas Craven Wall, M.D.
• Catherine Lauren Wallace, D.O.
• Celeste Nicole Wallace, D.O.
• Imani Wallace
• Sophia Pina Wallace
• Stephanie Dawn Wallace, SW
• Tiffany Wallace, DNP
• William Chase Wallen

• 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 Sep 4, 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.
• 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.