Calvin P Wallace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00024602 Issued in WA

Practice address

17700 SE 272ND St
Covington, WA 98042-4951

Phone

(253) 372-7128

NPI assigned

Jul 17, 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 WA

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

Interoperability endpoints

• Direct secure messaging: cwallacemd2944@direct.multicare.org

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  • Physical Therapist
  • Auburn, WA
  • NPI 1033622311
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • General Acute Care Hospital
  • Auburn, WA
  • NPI 1255327201
  NPD (past)
• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1922026236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299",
            "telephone_number": "253-372-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-372-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CALVIN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00024602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Wagner
• Wal-Mart Stores, Inc
• Lauren Jane Waldron, PT
• Walgreen Co
• Nicola E Walker, MD
• Walmart Inc.
• Hua Wang, LMT
• Lawrence Pei-Wen Wang
• Elizabeth Ann Warner, MD
• Washington Dental Corporation, PC

• Family Medicine Physician in Covington, WA
• Providers in Covington, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.