Amber Ann Wallace, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Spartanburg, SC
NPI 1104035526 · NPPES record last updated May 16, 2023
Key facts
- NPI
- 1104035526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD35398 (SC)
- Practice address
- 1686 Skylyn Dr
Suite 101
Spartanburg, SC 29307 - Phone
- (864) 560-3456
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spartanburg Medical Center
Practice addresses (Care Compare)
101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-6164
475 Heywood Ave
Spartanburg, SC 29307-1726
Phone (864) 699-5020
Hospital & facility affiliations
- Spartanburg Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.7 of 100
- Quality
- 89.4
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130510000556 | SC | Practitioner - Obstetrics/Gynecology | 4183877285 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35398 | SC | MD | Pharmacist |
| 01063765A | IN | MD | Obstetrics & Gynecology Physician |
| MD35398 | SC | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spartanburg Medical Center | Obstetrics & Gynecology | Current |
Accepting new patients |
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Scotland Memorial Hospital Inc | Current |
Accepting new patients | |
| Spartanburg Medical Center | Obstetrics & Gynecology | Current |
Accepting new patients |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Scotland Memorial Hospital Inc | Current |
Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients |
Locations
500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227
1007 Cheraw St
Bennettsville, SC 29512
Phone (843) 479-8357
853 N Church St
Ste 600
Spartanburg, SC 29303
Phone (864) 583-4556
1686 Skylyn Dr
Ste 102
Spartanburg, SC 29307
Phone (864) 560-5650
1686 Skylyn Dr
Ste 101
Spartanburg, SC 29307
Phone (864) 560-3456
853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928
475 Heywood Ave
Spartanburg, SC 29307
Phone (864) 699-5020
101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554
101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 2012-01577 | NC | |
| Obstetrics & Gynecology Physician | 207V00000X | MD35398 | SC | Yes |
| Obstetrics & Gynecology Physician | 207V00000X | 01063765A | IN |
Addresses
Primary practice location
1686 Skylyn Dr
Suite 101
Spartanburg, SC 29307
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SC07926162 | Other | SC | MEDICARE PIN |
| P01330093 | Other | SC | RAILROAD MEDICARE |
| NC1735 | Medicaid | SC | |
| SC07923365 | Other | SC | MEDICARE PIN |
Other names
- Amber Morris
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | awallace40586@direct-srhs.et0939.epichosted.com | Direct |
Other providers in Spartanburg, SC
- Jeffrey Allen Walker
- Lindsey A Walker
- Nicholas Wayne Walker
- Lacey Suttles Wall
- Melanie Wall
- Elizabeth Dashiell Wallace
- Shelley Brooke Wallace
- Susan Marie Wallace
- Kyla Wallaszek
- Steven Todd Wallenius
All providers in Spartanburg, SC · Obstetrics & Gynecology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.