AMANDA FRASER WALLACE


Address: 755 Heritage Rd, Golden, CO 80401-3600
Phone: 3032770700

AMANDA FRASER WALLACE (NPI# 1174750707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174750707
Entity Type Individual
Full Name AMANDA FRASER WALLACE
Credential MD
Practice Address 755 Heritage Rd
Golden
CO 80401-3600
Mailing Address 1818 E 7th Ave
Denver
CO 80218-3645
Practice Telephone 3032770700
Enumeration Date 2009-06-22
Last Update Date 2019-01-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207L00000X Anesthesiology DR0052096 CO Allopathic & Osteopathic Physicians
Y 207LP2900X Anesthesiology
Specialization: Pain Medicine
0052096 CO Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
888 S Auto Mall Rd, Bloomington, IN 474015430 8123532700 8123532701

Other Providers AMANDA WALLACE

NPI Name Taxonomy Address Enumeration
1518249838 Amanda Daniel Wallace Physician Assistant 655 Jesse Jewell Pkwy Se Ste B, Gainesville, GA 30501-3854 2011-09-13
1366635245 Amanda Wallace Counselor 1907 Kristy Ct, Longmont, CO 80504-7387 2007-08-23
1952808024 Amanda Marie Wallace Case Manager/Care Coordinator 205 Main St E, Mohall, ND 58761-4014 2018-04-06
1306345848 Amanda Cheyenne Wallace Student in an Organized Health Care Education/Training Program 3640 Colonel Glenn Hwy, Dayton, OH 45435-0001 2018-02-11
1972015659 Amanda Wallace Behavior Technician 41521 W 11 Mile Rd, Novi, MI 48375-1803 2017-11-02
1154844041 Amanda Gail Wallace Nurse Practitioner 142 Depot Dr, South Shore, KY 41175-9306 2017-07-21
1578097341 Amanda Wallace Physical Therapist 2115 Dulles Dr, Lafayette, LA 70506-2652 2017-04-18
1649665977 Amanda Rose Wallace Psychiatry & Neurology 525 E 68th St, New York, NY 10065 2015-04-03
1972908010 Amanda Jo Wallace Psychologist 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 2014-10-31
1578964888 Amanda Leigh Wallace Speech-Language Pathologist 928 W Market St, Tiffin, OH 44883-2529 2014-09-07

Office Location

Street Address 755 HERITAGE RD
City GOLDEN
State CO
Zip Code 80401-3600

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245282862 Robert Z Moghim Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2006-05-16
1063943611 Hortense Mbwenze Ngoe Nurse Practitioner 755 Heritage Rd, Ste 100, Golden, CO 80401-3600 2017-03-24
1982062337 Emmanuela Agwu Nurse Practitioner 755 Heritage Rd, Ste 100, Golden, CO 80401-3600 2016-01-31
1073986980 Rachael Passafaro Physician Assistant 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2015-11-02
1619344066 Arizona Pain Specialists, Pllc Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2015-09-01
1528400082 Colorado Pain Care, LLC Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2013-07-25
1962796342 Ajay Rajkumar Vellore Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2011-06-03
1134331101 Jordanna Quinn Physical Medicine & Rehabilitation 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2007-05-04
1881726891 Red Rocks Center for Rehabilitation Specialist 755 Heritage Rd, Sutie 100, Golden, CO 80401-3600 2007-03-12
1124107909 Jeffrey Kesten Physical Medicine & Rehabilitation 755 Heritage Rd, #100, Golden, CO 80401-3600 2006-11-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093315152 Ruth Lucia Settak Social Worker 17301 W. Colfax Ave., Ste 200, Golden, CO 80401 2020-10-28
1811457088 Evening Elegance LLC Prosthetic/Orthotic Supplier 14500 W Colfax Ave Unit 246, Lakewood, CO 80401 2019-03-22
1255853826 Angela Kathryn Brickman Behavior Technician 714 Ridgeside Drive, Golden, CO 80401 2017-07-14
1710408240 Catherine Camacho Psychologist 913 Arapahoe St, Golden, CO 80401 2017-07-06
1710420492 Colorado Complete Urgent Care Physicians LLC Clinic/Center 17101 S Golden Rd., Golden, CO 80401 2016-11-29
1366991051 Britta Marie Olson Physical Therapist 600 Golden Ridge Rd, Suite 130, Golden, CO 80401 2016-09-23
1003284209 Maria Alta Mcvey Dental Hygienist 2305 Jackson St., Golden, CO 80401 2015-09-04
1548644479 Christine Rodriguez Dental Hygienist 2305 Jackson Street, Golden, CO 80401 2015-07-09
1508285776 Colorado Pain Practice, Pllc Anesthesiology 755 Heritage Road, Suite 100, Golden, CO 80401 2014-04-15
1942644844 Golden Kids Dental Dentist 2421 Ford St., Golden, CO 80401 2013-04-22
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Taxonomy Information

Taxonomy Code 207LP2900X
Grouping Allopathic & Osteopathic Physicians
Classification Anesthesiology
Specialization Pain Medicine

Taxonomy Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508285776 Colorado Pain Practice, Pllc Anesthesiology 755 Heritage Road, Suite 100, Golden, CO 80401 2014-04-15
1932387966 Daniel Alan Drennan Anesthesiology 400 Indiana St Ste 320, Golden, CO 80401-5033 2008-01-31
1245282862 Robert Z Moghim Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2006-05-16
1619344066 Arizona Pain Specialists, Pllc Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2015-09-01
1447631361 Andrew J Wendahl Anesthesiology 400 Indiana St Ste 320, Golden, CO 80401-5033 2015-06-16
1528400082 Colorado Pain Care, LLC Anesthesiology 755 Heritage Rd, Suite 100, Golden, CO 80401-3600 2013-07-25
1457600231 Daniel S Bennett Md PC Anesthesiology 14828 W 6th Ave, Ste 16-b, Golden, CO 80401-5000 2012-09-07
1447496377 Ambulatory Anesthesia Consultants PC Anesthesiology 1819 Denver West Dr, Suite 200, Golden, CO 80401-3118 2008-12-24
1902999352 Jason Krutsch Anesthesiology 755 Heritage Rd, #100, Golden, CO 80401-3600 2006-09-30
1255355467 Daniel S Bennett Anesthesiology 14828 W 6th Ave, Ste 16-b, Golden, CO 80401-5000 2006-07-27
Find all providers in GOLDEN

Competitor

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City GOLDEN
Zip Code 80401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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