Eric Lee Wallace, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

71205 Issued in TN

Practice address

145 W 4TH St Ste 201
Cookeville, TN 38501-2476

Phone

(931) 783-5515

Fax

(931) 783-5513

NPI assigned

Jul 4, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in NC, TN2 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

Vanderbilt University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cookeville Regional Medical CenterGroup PAC ID 7810805736, 51 clinicians

Middle Tennessee Surgical Specialists, LLCGroup PAC ID 9133014707, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: eric.wallace.1@10383.direct.athenahealth.com

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.

• Cookeville Regional Medical Center

  • Hospitalist Physician
  • Cookeville, TN
  • NPI 1023397031
  Medicare reassignment Care Compare group NPD
• Middle Tennessee Surgical Specialists, LLC

  • Specialist
  • Cookeville, TN
  • NPI 1134212640
  Medicare reassignment Care Compare group NPD
• Surgical Specialists of Charlotte, P.a.

  • Surgery Physician
  • Charlotte, NC
  • NPI 1073599734
  Medicare reassignment NPD
• Cookeville Regional Medical Center

  • Rehabilitation Hospital Unit
  • Cookeville, TN
  • NPI 1639293483
  NPD
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  NPD (past)
• Middle Tennessee Surgical Associates, PLLC

  • Surgery Physician
  • Manchester, TN
  • NPI 1275827875
  NPD (past)
• Charlotte Trauma Services, PLLC

  • Trauma Surgery Physician
  • Charlotte, NC
  • NPI 1285610956
  NPD (past)
• The Charlotte-Mecklenburg Hospital Authority

  • General Practice Physician
  • Charlotte, NC
  • NPI 1477627388
  NPD (past)

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

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1780614529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-783-5515",
            "fax_number": "931-783-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 4TH ST STE 201",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012476",
            "telephone_number": "931-783-5515",
            "fax_number": "931-783-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERIC",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "71205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q096326",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Walker, LPN
• Derek Walker
• Emily Claire Coleman Walker, FNP
• Kristin Steele Walker, BEHAVIOR TECHNICAN
• Emily Wallace
• Natalie N Wallace
• William Jacob Wallace, PA
• Amy Catherine Ward, BS
• Tiffany Ward, FNP
• Washington Ave Family Practice

• Surgery Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.