Michael H Wallace, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37120 Issued in IA

Practice address

788 8TH Avenue SE
Suite 204
Cedar Rapids, IA 52401

Phone

(319) 398-6342

Fax

(319) 558-0330

NPI assigned

Oct 4, 2006

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

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mercy Care Management, Inc

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1467659268
  Medicare reassignment NPD
• Mercy Physician Associates, Inc

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1427254952
  Medicare reassignment NPD
• Mercy Care Management, Inc

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1306042890
  NPD
• Mercy Physician Associates Inc

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1619554086
  NPD
• Mercy Physician Associates, Inc

  • Family Medicine Physician
  • North Liberty, IA
  • NPI 1306118310
  NPD
• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1922012764
  NPD (past)
• Genesis Medical Education Foundation Inc

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1659322931
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1801982475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 8TH AVENUE SE",
            "address_2": "SUITE 204, MERCY EMPLOYEE HEALTH CENTER",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52401",
            "telephone_number": "319-398-6342",
            "fax_number": "319-558-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 8TH AVENUE SE",
            "address_2": "SUITE 204",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52401",
            "telephone_number": "319-398-6342",
            "fax_number": "319-558-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "37120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Louis Walker, DDS MS
• Todd Marvin Walker, DDS
• Brandon Earl Wall, LMFT
• Philly Marie Wall, P.A.
• Alexander M Wallace, DC
• Christine Wallen, DC
• Carsyn Lynn Waller, MA, CCC-SLP
• Walmart Inc.
• Walmart Inc.
• Jessica Walter, COTA/L

• Family Medicine Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.