Sara Davis Wallace, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23661 Issued in SC

Practice address

600 E Palmetto St
Florence, SC 29506-2851

Phone

(843) 667-9414

NPI assigned

Jul 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Merit-based Incentive Payment System (MIPS)

Final score

95.78 of 100Reported as group

Quality

81.28

Promoting interoperability

100

Improvement activities

40

Cost

80.81

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swallace928964@direct.unc.nchie.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.

• Unc Physicians Network LLC

  • Family Medicine Physician
  • Pittsboro, NC
  • NPI 1750704367
  Medicare reassignment Care Compare group NPD
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment NPD
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1427282045
  Medicare reassignment NPD
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD
• Hopehealth, Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1114353786
  NPD
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1265165518
  NPD
• Unc Physicians Network LLC

  • General Practice Physician
  • Morrisville, NC
  • NPI 1558786830
  NPD

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

• Southeastern Regional Medical Center

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1750908174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E PALMETTO ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062851",
            "telephone_number": "843-667-9414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 Independence Dr",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283582328",
            "country_code": "US",
            "telephone_number": "910-738-9414",
            "fax_number": "910-738-1012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SARA",
        "middle_name": "DAVIS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swallace928964@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4760 Independence Dr",
            "city": "Lumberton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283582328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasmika Wallace
• Kelsey Wallace
• Lisa M. Wallace, FNP
• Mandy L Wallace, MSRPT
• Robert Brian Wallace, O.D.
• Jazzmine Walley
• Sharon A Walters, FNP
• Walton Accident & Injury Clinic, LLC
• Walton Accident Clinic, LLC
• Walton Family Chiropractic Clinic, LLC

• Family Nurse Practitioner in Florence, SC
• Providers in Florence, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.