Individual provider Active NPI

Noel Wallace, M.D.

  • Obstetrics & Gynecology Physician
  • Lafayette, IN
National Provider Identifier
1730227679
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01066906A Issued in IN
Practice address
5177 McCarty LN
Lafayette, IN 47905-8764
Phone
(765) 448-8000
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A98239 CA
Obstetrics & Gynecology Physician 207V00000X 01066906A IN Primary

Addresses

Primary practice location

5177 McCarty LN
Lafayette, IN 47905-8764

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other identifiers 2

IdentifierTypeStateIssuer
200950700MedicaidIN
000000623454OtherINANTHEM PROVIDER NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nwallace@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20091008000310 IN Practitioner - Obstetrics/Gynecology 1951447754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2600 Greenbush St
Lafayette, IN 47904-2477
Phone (765) 448-8000

Hospital & facility affiliations

  • Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A98239CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Obstetrics & Gynecology CurrentSince Jul 31, 2009 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Arnett Clinic, LLC CurrentSince Jul 31, 2009 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

1300 S Jackson St
Frankfort, IN 46041
Phone (765) 656-3000

550 S Hoke Ave
Frankfort, IN 46041
Phone (765) 659-1110

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2600 Ferry St
Lafayette, IN 47904

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

2600 Greenbush St
Lafayette, IN 47904

938 Mezzanine Dr
Ste B
Lafayette, IN 47905
Phone (765) 742-1533

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

720 S 6th St
Monticello, IN 47960
Phone (574) 583-1776

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

1104 E Grace St
Rensselaer, IN 47978
Phone (219) 866-2026

Interoperability endpoints

  • Direct secure messaging: nwallace@direct.iuhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1730227679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5177 MCCARTY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058764",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NOEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A98239",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01066906A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200950700",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000623454",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwallace@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "5177 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.