Cynthia R Wallace, C.N.M.

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN046062 Issued in GA

Practice address

2060 Dan Proctor Dr
Suite 1200
Saint Marys, GA 31558-3894

Phone

(912) 540-6750

Fax

(912) 540-6773

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

No

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Emory University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146

Merit-based Incentive Payment System (MIPS)

Final score

76.36 of 100Reported as group

Quality

46.72

Promoting interoperability

99

Improvement activities

40

Cost

75.31

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwallac@secure.sghsmessaging.org

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.

• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402
  Medicare reassignment Care Compare group NPD

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

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Camden Campus

  • General Acute Care Hospital
  • Saint Marys, GA
  • NPI 1194744326
  Care Compare affiliation

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1528257268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 DAN PROCTOR DR",
            "address_2": "SUITE 1200",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583894",
            "telephone_number": "912-540-6750",
            "fax_number": "912-540-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 DAN PROCTOR DR",
            "address_2": "SUITE 1200",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583894",
            "telephone_number": "912-540-6750",
            "fax_number": "912-540-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CYNTHIA",
        "middle_name": "R",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN046062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00668885A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laila Wahid
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0836)
• Wal-Mart Stores East, LP (Vision Center 30-0836)
• Amber Patrice' Walker-Ramsey
• Jenny Walker, LMSW
• Valerie Lynne Waltz
• Bethany Norman Ware, CNM
• Victoria Yalonda Warner-White, M.D.
• Akira Warren
• Tabetha Anne Watts, PMHNP-BC

• Advanced Practice Midwife in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Advanced Practice Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.