William Wallace Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

86402 Issued in GA

Practice address

777 Hemlock St
Macon, GA 31201

Phone

(478) 633-1000

NPI assigned

Mar 24, 2017

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

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

General Surgery

Education

University of Oklahoma College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
• Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201
• Atrium Health Navicent Peach Hospital, Byron, GA, CCN 111310
• Fairview Park Hospital Hospital, Dublin, GA, CCN 110125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wwallace433233@carolinashealthcaresystem.direct-ci.com

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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Surgery

  Medicare reassignment Care Compare group NPD
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Park, Limited Partnership

  dba Fairview Park Hospital

  • General Acute Care Hospital
  • Dublin, GA
  • NPI 1285688234
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Perry

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Warner Robins

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation
• Macon Northside Hospital, LLC

  dba Piedmont Macon North Hospital

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1811940976
  Care Compare affiliation
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  Care Compare affiliation
• The Medical Center of Peach County, Inc

  dba Atrium Health Navicent Peach

  • Critical Access Hospital
  • Byron, GA
  • NPI 1114923406
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1487185054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-633-1891",
            "fax_number": "478-633-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-633-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "86402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleopatra Wallace, CRNA
• Danielle Wallace
• Franc Wallace, MD
• Heather E Wallace
• Lisa Marie Wallace, CRNA
• Ryan C. Wallentine, PA-AA
• Waller Occupational Therapy and Consulting, LLC
• Eulanda Lara Waller, OTR/L
• Laura B Walsh, LPC
• Heather Michele Walters, PHARMD

• Surgery Physician in Macon, GA
• Providers in Macon, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.