Kojo Wallace, MD

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

0101285554 Issued in VA

Practice address

Centra Lynchburg General Hospital
1901 Tate Springs Rd
Lynchburg, VA 24501

Phone

(434) 200-3000

NPI assigned

Apr 15, 2015

Last updated

Jul 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY, VA2 enrollments

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 2

Specialty

General Surgery

Education

Icahn School of Medicine at Mount Sinai, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Multi-Specialty

  Medicare reassignment NPD

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

• Centra Health Inc

  • General Acute Care Hospital
  • Lynchburg, VA
  • NPI 1770693939
  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba Centra Health Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1407884448

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • Lynchburg, VA
  • NPI 1811925852

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Wound Care Center

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
  • NPI 1902834948

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba CMG Vascular Surgery

  • Vascular Surgery Physician
  • Lynchburg, VA
  • NPI 1144880782

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Medical Group Stroobants Cardiovascular Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1184964124

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Lynchburg Hematology and Oncology

  • Hematology & Oncology Physician
  • Lynchburg, VA
  • NPI 1700293628

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1720475866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 STATION WAY",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRA LYNCHBURG GENERAL HOSPITAL",
            "address_2": "1901 TATE SPRINGS RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24501",
            "telephone_number": "434-200-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KOJO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "VA",
            "license": "0101285554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lloyd Henry Walker, PA
• Johnathan Walkine
• Joseph Charles Preston Wall, LPC
• Deaven McGuire Wallace, MA, LPC
• Donald McQuire Wallace, DDS
• William Miles Wallace
• Brenda Sue Waller, M.D.
• Sandra Waller, CERTIFIED HAIR LOSS
• John Wallman, PT
• Mary Wallman, PT

• Trauma Surgery Physician in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Trauma Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.