Margaret Wallace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71860 Issued in MA

Practice address

415 Columbia Rd
Dorchester, MA 02125-2424

Phone

(617) 740-8077

NPI assigned

Feb 10, 2006

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 MA

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

Medicare enrollment (NPD)

Enrolled

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.

• Upham'S Corner Health Committee, Inc.

  • Community Health Clinic/Center
  • Dorchester, MA
  • NPI 1780780486
  Medicare reassignment NPD

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669445425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252424",
            "telephone_number": "617-740-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "71860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Eastern Co Inc
• Debra Wallace
• Jacqueline Wallace
• Melissa A Wallace, EDM
• Laura Anne Walsh, RN
• Margaret R Walsh
• Tracy Michelle Walters
• Tre' Lamar Walton

• Family Nurse Practitioner in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.