William C Wallace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21450 Issued in WV

Practice address

1600 Medical Center Dr
Suite G500
Huntington, WV 25701-3656

Phone

(304) 691-1262

NPI assigned

Mar 23, 2006

Sex

Male

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

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

JC Edwards School of Medicine, Marshall University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physicians and Surgeons, IncGroup PAC ID 2961315734, 379 clinicians

Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.wallace@marshall.cernerdirect.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.

• University Physicians & Surgeons, Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1730183286

  Family Medicine

  Medicare reassignment Care Compare group NPD
• University Physicians & Surgeons, Inc.

  • Health & Wellness Coach
  • Louisa, KY
  • NPI 1073256665
  NPD

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

• Cabell Huntington Hospital Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1073518007
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1619937851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE G500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE G500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000190",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082704",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2583128",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "william.wallace@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite G500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janet Nease Wallace, M.D.
• Lakyn Julia Wallace
• Mary Frances Wallace, LMT
• Montana Wallace
• Troy Wallace, M.D.
• Amy Jo Waller
• Debra Wallin
• Aleacha Faith Wallington, DPT
• Joseph M Wallis, CRNA
• Ashlee E Walls, LPC

• Family Medicine Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.