Wallace Beverly McLeod III, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15393 Issued in OK

Practice address

2216 N Martin Luther King Ave
Oklahoma City, OK 73111-2404

Phone

(405) 424-0111

Fax

(405) 424-0115

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Howard University College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Wallace B. McLeod III, Inc

  • Ph.D. Medical Genetics
  • Oklahoma City, OK
  • NPI 1861711731
  Medicare reassignment
• Wallace B McLeod III, Inc

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1194044313
  NPD

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

• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1922035237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 N MARTIN LUTHER KING AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731112404",
            "telephone_number": "405-424-0111",
            "fax_number": "405-424-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 N MARTIN LUTHER KING AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731112404",
            "telephone_number": "405-424-0111",
            "fax_number": "405-424-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "WALLACE",
        "middle_name": "BEVERLY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "15393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP  NPI",
            "identifier": "1861711731",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "15393",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah McLennon
• Ashley McLeod, CFY-SLP
• Jessica McLeod, LCSW
• Michael Preston McLeod, D.D.S.
• Stacy Maria McLeod, LPN
• Patricia D McLinn
• Jeannie McMahan, M.ED, LPC
• Michael Zann McMahan, MD
• Kalyn McMahon
• Kimberly McMahon

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.