Lars Erik Wallin III, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

73340 Issued in TN

Practice address

1325 Wolf Park Dr Ste 102
Germantown, TN 38138-1759

Phone

(901) 252-3400

Fax

(901) 763-4305

NPI assigned

May 22, 2013

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Urology

Education

University of Toledo College of Medicine, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Conrad Pearson Clinic PC

  • Multi-Specialty Clinic/Center
  • Germantown, TN
  • NPI 1992758882

  Urology

  Medicare reassignment NPD
• Conrad Pearson Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Cordova, TN
  • NPI 1285486241

  Urology

  NPD
• Conrad Pearson Clinic

  • Medical Specialty Clinic/Center
  • Germantown, TN
  • NPI 1174864946
  NPD (past)
• St Luke'S Magic Valley Regional Medical Center LTD

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1821434457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3500",
            "fax_number": "901-763-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3145 Players Club Pkwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381258835",
            "country_code": "US",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "LARS",
        "middle_name": "ERIK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "73340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Godsey Wall, APRN
• Blake Wallace
• Jennifer Wallace
• Donald Gavin Walley, D.D.S
• Glenda Loyd Walley, D.D.S
• Robert B Walter, DPH
• Cinda A Walz, MA, CCC-SLP
• Yuefeng Wang, MD
• Warby Parker Inc.
• Jason Douglas Ward, P.T.

• Urology Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.