James John Wallace, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5182 Issued in TN

Practice address

360 E Eh Crump Blvd
Memphis, TN 38126-5394

Phone

(901) 261-2000

Fax

(901) 946-9262

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1988

Medicare assignment

May accept Medicare assignment

Group practices

Memphis Health Center, Inc.Group PAC ID 7315859972, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: james.wallace.1@20250.direct.athenahealth.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.

• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1144236902
  Medicare reassignment Care Compare group NPD
• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1659745354
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD (past)
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Oconto, WI
  • NPI 1699926964
  NPD (past)
• St Clare Memorial Hospital, Inc

  • Critical Access Hospital
  • Oconto Falls, WI
  • NPI 1851477913
  NPD (past)
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, WI
  • NPI 1699778233
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1538196704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-2000",
            "fax_number": "901-946-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-2000",
            "fax_number": "901-946-9262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4940 Highway 57",
            "address_purpose": "LOCATION",
            "city": "Rossville",
            "state": "TN",
            "postal_code": "380665068",
            "country_code": "US",
            "telephone_number": "901-261-7303",
            "fax_number": "901-946-9262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4593 Elvis Presley Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381161511",
            "country_code": "US",
            "telephone_number": "901-261-7338",
            "fax_number": "901-946-9262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JAMES",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28115-021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "5182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30027800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00983439",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5182",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wallace Plastic Surgery Group, PLLC
• Wallace Urology Inc
• Carrie Wallace
• David Alexander Wallace
• Jacquel Wallace, PHARMD
• Jennifer F. Wallace, NP
• Jennifer Lynn Wallace
• Landon J Wallace, O.D.
• Lee S. Wallace, MS, RD, LDN, FADA
• Madison Wallace

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, 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 26, 2024; 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.