JEFFREY WALLACE (NPI# 1215027990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215027990 |
| Entity Type | Individual |
| Full Name | JEFFREY WALLACE |
| Credential | MD |
| Practice Address |
12605 E 16th Ave Aurora CO 80045-2545 |
| Mailing Address |
Po Box 876 Aurora CO 80040-0876 |
| Practice Telephone | 7208480000 |
| Mailing Telephone | 3034937000 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
27855 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 37850539 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629089156 | Jeffrey S Wallace | Orthopaedic Surgery | 6800 Heritage Pkwy Ste 102, Rockwall, TX 75087-8746 | 2006-08-10 |
| 1821014838 | Jeffrey W Wallace | Dentist | 74 Grafton Rd, Townshend, VT 05353-0262 | 2006-07-14 |
| 1568499234 | Jeffrey A. Wallace I | Pharmacist | 5420 Lancaster Dr, Kaiser Permanente Pharmacy Administration, Brooklyn Heights, OH 44131-1832 | 2006-06-27 |
| 1679563928 | Jeffrey David Wallace | Chiropractor | 820 Charlevoix Dr, Suite 210, Grand Ledge, MI 48837-8188 | 2005-10-27 |
| 1548262108 | Jeffrey Leigh Wallace | Preventive Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2005-08-12 |
| 1538557012 | Jeffrey Eugene Wallace | Counselor | 400 S Jefferson St Ste 200, Spokane, WA 99204-3143 | 2015-01-06 |
| 1619392974 | Jeffrey Michael Wallace | Physician Assistant | 600 Caisson Hill Rd, Fort Riley, KS 66442-7037 | 2014-02-24 |
| 1306006796 | Jeffrey Robert Wallace | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Building B Suite 2300, Atlanta, GA 30322-1013 | 2008-06-10 |
| 1649479171 | Jeffrey W Wallace | Physician Assistant | 112 Piper Hill Dr, First Floor, Saint Peters, MO 63376-1690 | 2007-07-14 |
| 1003866419 | Jeffrey Neil Wallace | Chiropractor | 330 140 Village Rd, Unit 9a, Westminster, MD 21157-6127 | 2006-05-10 |
| Street Address |
12605 E 16TH AVE |
| City | AURORA |
| State | CO |
| Zip Code | 80045-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556694 | Mark Armin Levine | Internal Medicine | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2005-05-23 |
| 1962001719 | Poudre Valley Medical Group, LLC | Social Worker | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-22 |
| 1811595473 | Jason Hayes | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-15 |
| 1710584560 | Alleson Bayer | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-10-05 |
| 1316554009 | Lisa Najera | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-09-26 |
| 1699382705 | James Lloyd Martin Jr. | Pharmacy | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-09-23 |
| 1740808575 | Beth Lee Smilkstein | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-07-08 |
| 1780200907 | Amanda Marie Miller-sarmento | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-23 |
| 1558987909 | Heather Ann Sutton | Counselor | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-22 |
| 1982220349 | Rocco James Miele | Nurse Practitioner | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2020-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
| 1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
| 1487278719 | James Charles Tuka IIi | Social Worker | 1700 North Wheeling, Aurora, CO 80045 | 2020-06-02 |
| 1427677806 | Justin Yu | Student in an Organized Health Care Education/Training Program | 12631 E. 17th Ave. Ms B205, Aurora, CO 80045 | 2020-04-15 |
| 1558980011 | Erik Von Polsdofer | Student in an Organized Health Care Education/Training Program | Academic Office 1; Department of Pathology, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-04-14 |
| 1831718568 | Luke Porter Bacon | Student in an Organized Health Care Education/Training Program | 3001 East 17th Place, Aurora, CO 80045 | 2020-04-13 |
| 1366061368 | Hilary Novatt | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave, B198-6, Room 4007, Aurora, CO 80045 | 2020-04-10 |
| 1376195362 | Katie Tuck | Pharmacist | 1700 North Wheeling Street (119), Fs-111o, Aurora, CO 80045 | 2019-07-10 |
| 1518529130 | Ronak Kamal Kapadia | Student in an Organized Health Care Education/Training Program | 12700 E. 19th Ave, Ms B182 Rm 5104, Aurora, CO 80045 | 2019-07-03 |
| 1245898253 | Rasha Elbadry Ahmed | Student in an Organized Health Care Education/Training Program | Childrens Hospital Colorado Pediatric Neurosurgery, 13123e. 16th Ave, B330, Aurora, CO 80045 | 2019-06-04 |
| Find all providers in zip 80045 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932528247 | Ian Reynolds | Internal Medicine | 13001 E 17th Pl # P, Aurora, CO 80045-2570 | 2014-04-15 |
| 1528232402 | Shalom Park Professional Services LLC | Internal Medicine | 14800 E Belleview Drive, Aurora, CO 80015-2258 | 2008-04-22 |
| 1821289752 | William A Solomon, Md, P.C. | Internal Medicine | 3140 S Peoria St # 266, Aurora, CO 80014-3178 | 2007-08-06 |
| 1700950615 | Paul Joseph Wright | Internal Medicine | 3551 Chambers Rd, Aurora, CO 80011-1330 | 2006-11-20 |
| 1588625214 | William A Solomon | Internal Medicine | 3124 S Parker Rd # A2-266, Aurora, CO 80014-6215 | 2006-03-31 |
| 1972069375 | Colorado Senior Care Services, P.C. | Internal Medicine | 1400 S Potomac St Ste 150, Aurora, CO 80012-4541 | 2019-02-11 |
| 1679052377 | University Physicians Incorporated | Internal Medicine | 1635 Aurora Ct Fl 5, Aurora, CO 80045-2541 | 2018-08-13 |
| 1679936629 | Sarah Tietz | Internal Medicine | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2016-03-29 |
| 1275813297 | Preferred Provider Services, LLC | Internal Medicine | 3025 S Parker Rd, Suite 100, Aurora, CO 80014-2911 | 2011-08-22 |
| 1245523539 | Bobaker Saddek Elalem | Internal Medicine | 2550 S Parker Rd, Suite 400, Aurora, CO 80014-1622 | 2011-05-19 |
| Find all providers in AURORA | ||||
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| 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.