Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1912977885 Individual Practitioner Female Practitioner

Dr. Jennifer Wallace , MD

Pediatrics • Gilbert, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Jennifer Wallace, MD is a registered healthcare professional specializing in Pediatrics in Gilbert, AZ. Practice services are available at 2550 E GUADALUPE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2550 E Guadalupe Rd
#115

Gilbert, AZ 852345114

Telephone 4806321544
Fax 4806321533
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Gilbert, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 23.5 Yrs
Regional Practice Density
53 Specialists

Practicing in Gilbert, AZ (1353 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License AZ 31229

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
831124 (AZ)
Commercial Insurance / Payer ID Mayo Insurance
031229 (AZ)
Commercial Insurance / Payer ID Dept. Of Economic Securit
8311240 (AZ)
Commercial Insurance / Payer ID Blue Cross Blue Shield
AZ0734620 (AZ)
Commercial Insurance / Payer ID Healthnet
1Z9881 (AZ)
Commercial Insurance / Payer ID Banner Health Plan
00024623 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
William Gause , PA-C

Physician Assistant - Medical

NPI 1407955065

Physician Assistant (Certified)

Stefanie Laystrom , PA-C

Physician Assistant

NPI 1447429824

Physician Assistant (Certified)

Grace Hannon , PA

Physician Assistant

NPI 1497156327

Physician Assistant

NPI 1932555828

Doctor of Medicine (M.D.)

NPI 1972572832

Doctor of Medicine (M.D.)

NPI 1982010765

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2550 E GUADALUPE RD, #115, GILBERT, AZ 852345114 (Tel: 4806321544)

📍
Updated Business Mailing Address July 08, 2007

Registered at 6301 S MCCLINTOCK DR, #101, TEMPE, AZ 852833392 (Tel: 4802142300)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JENNIFER WALLACE, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #31229 in AZ)

🟢
Initial NPI Registration & Enumeration January 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1912977885
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 24, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

6301 S Mcclintock Dr, #101

Tempe, AZ 852833392

Phone: 4802142300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.