Peggy Lynn Wallace, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

114266-4405 Issued in UT

Practice address

2132 N 1700 W, Ste 100
Layton, UT 84041-7059

Phone

(801) 807-7900

Fax

(801) 807-7904

NPI assigned

Jul 15, 2021

Sex

Female

Sole proprietor

Yes

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 UT

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Nursing Services Home health agency, West Valley City, UT, CCN 467001
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score

89.06 of 100Reported as group

Quality

89.53

Promoting interoperability

100

Improvement activities

40

Cost

74

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Catholic Health Initiatives Colorado

  • Prescribing (Medical) Psychologist
  • West Valley City, UT
  • NPI 1942903562
  Medicare reassignment Care Compare group NPD
• Catholic Health Initiatives Colorado

  • Obstetrics & Gynecology Physician
  • Layton, UT
  • NPI 1851093199
  NPD
• Catholic Health Initiatives Colorado

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD
• Advanced Health Clinic

  • Specialist
  • Farmington, UT
  • NPI 1386863108
  NPD (past)
• Catholic Health Initiatives Colorado

  • Neurological Surgery Physician
  • Lakewood, CO
  • NPI 1205846664
  NPD (past)

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839
  Care Compare affiliation
• Community Nursing Service

  • Home Health Agency
  • West Valley City, UT
  • NPI 1497703870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1841862059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E 1675 N",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844043379",
            "telephone_number": "801-675-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 N 1700 W, STE 100",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417059",
            "telephone_number": "801-807-7900",
            "fax_number": "801-807-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "PEGGY",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "114266-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Walker
• Tamra Walker
• Wendy Walkowiak
• Brent Wall, DO
• Marisa Wall
• Richard K Wallin, MD
• Trevin Richard Wallin, M.D.
• Walmart Inc.
• Walmart Inc.
• Donna P Walters, LCSW

• Nurse Practitioner in Layton, UT
• Providers in Layton, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.