Michelle Wallace, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

064090 Issued in GA

Practice address

202 Village Center Pkwy
Stockbridge, GA 30281-9044

Phone

(404) 256-2593

Fax

(770) 488-9408

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Cardiovascular Disease (Cardiology)

Education

Morehouse School of Medicine, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Children'S Healthcare of Atlanta Cardiology IncGroup PAC ID 6901888395, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwallace41563@choa.gadirect.net

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.

• Childrens Healthcare of Atlanta Cardiology Inc

  • Pediatric Cardiology Physician
  • Atlanta, GA
  • NPI 1235148727
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1316111719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 BRANDYWINE RD STE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415521",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 VILLAGE CENTER PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819044",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "064090",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "141727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "202 Village Center Pkwy",
            "city": "Stockbridge",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302819044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Asya Walker
• D'Mya N Walker, SLP
• Erica Walker, CPNP
• Nakeiya Shanae Walker, RBT, MA
• Laura J Wallace, CNM
• Karen Klamon Walters, LAPC, NCC
• Myngnon Denise Walton, LAPC, CAMS
• Ashley Wang
• Amoy Ward
• Marjorie J Warren, M.D.

• Pediatric Cardiology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatric Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.