William Fredrick Wallace, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

060513 Issued in GA

Practice address

11700 Mercy Blvd
Building 6
Savannah, GA 31419-1753

Phone

(912) 927-3434

NPI assigned

Feb 19, 2007

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 2

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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

University of Mississippi School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph'S Cardiology Group LLCGroup PAC ID 3274770227, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142
• Candler Hospital Hospital, Savannah, GA, CCN 110024
• Candler County Hospital Hospital, Metter, GA, CCN 111334

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: williamwallace@cas.allscriptsdirect.net

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.

• St. Joseph'S Cardiology Group, LLC

  • Interventional Cardiology Physician
  • Savannah, GA
  • NPI 1619216058
  Medicare reassignment Care Compare group NPD
• Landmark Hospital of Savannah LLC

  • Long Term Care Hospital
  • Savannah, GA
  • NPI 1023436102
  Medicare reassignment NPD
• Landmark Hospital of Savannah LLC

  • Skilled Nursing Facility
  • Savannah, GA
  • NPI 1861944019
  NPD

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

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Evans Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Claxton, GA
  • NPI 1730110826
  Care Compare affiliation
• Hospital Authority of Candler County

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1700920154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 MERCY BLVD",
            "address_2": "BLVD 6",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191753",
            "telephone_number": "912-927-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 MERCY BLVD",
            "address_2": "BUILDING 6",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191753",
            "telephone_number": "912-927-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "060513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "581114452A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "1700920154",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Wallace
• Heather Morgan Wallace, MD
• Ray L Wallace Jr., PA
• Synthia Joy-Best Wallace, LAPC
• Timothy Brian Wallace, MD
• Debra Keefe Walland, MD
• Jason Lee Waller, PHARMD
• Suzanne Waller, BSN, RN
• Christopher E. Walls, M.D
• Alison Walmsley, OTR

• Interventional Cardiology Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.