Rodger T Wallace, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD6949 Issued in TN

Practice address

341 Wallace Rd
Suite a
Nashville, TN 37211-8000

Phone

(615) 834-7744

Fax

(615) 834-7786

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Columbia Medical Group-Southern Hills Inc

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1700873171
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346359205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WALLACE RD",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118000",
            "telephone_number": "615-834-7744",
            "fax_number": "615-834-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 WALLACE RD",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118000",
            "telephone_number": "615-834-7744",
            "fax_number": "615-834-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "RODGER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD6949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3419805",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliet Paige Wallace, PHARM.D.
• Karen Wallace
• Kathryn Wallace
• Matthew Wallace
• Nikki L Wallace, CRNA
• Roy Trent Wallace, MD
• Sarah Wallace, PA
• Stuart C Wallace, CRNA
• Tift Palmer Wallace, CPNP
• Ahreanna Wallen, LMSW

• Family Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.