Rex Michael Wallace, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN286080 Issued in GA

Practice address

1061 Dowdy Rd
Athens, GA 30606-5700

Phone

(706) 621-7555

NPI assigned

Jul 17, 2025

Last updated

Oct 9, 2025By the provider in NPPES

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

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

Family Practice

Education

University of Alabama School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reddy Urgent Care LLCGroup PAC ID 5890932966, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reddy Urgent Care LLC

  dba Athens Reddy Urgent Care

  • Urgent Care Clinic/Center
  • Athens, GA
  • NPI 1922356179
  Medicare reassignment Care Compare group NPD
• Reddy Urgent Care LLC

  dba Reddy Urgent Care Royston

  • Urgent Care Clinic/Center
  • Royston, GA
  • NPI 1982287546
  NPD

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1629960315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 MAULDIN RD",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305491308",
            "telephone_number": "706-654-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 DOWDY RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065700",
            "telephone_number": "706-621-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "REX",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN286080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Wall
• Anthony Wall, N.P.
• Kelly E. Wall, ANP-BC
• Amanda Daniel Wallace, PA-C
• Ansley Wallace
• Stephanie Ruth Wallace, APRN-NP
• Esther Wimlen Wallach, M.D., M.SC.
• Jessica D Waller, NP
• Valerie D Waller
• Barbette Walls, RN

• Family Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.