Individual provider Active NPI

Timothy Brian Wallace, MD

  • Anesthesiology Physician
  • Savannah, GA
National Provider Identifier
1841215902
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
027684 Issued in GA
Practice address
6605 Abercorn St
Suite 108
Savannah, GA 31405-5815
Phone
(912) 355-7214
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 1024734 MA
Anesthesiology Physician 207L00000X 027684 GA Primary

Addresses

Primary practice location

6605 Abercorn St
Suite 108
Savannah, GA 31405-5815

Mailing address

6605 Abercorn St
Suite 108
Savannah, GA 31405-5815
Phone (912) 355-7214

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 856-3271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MA2 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

Enrollment IDStateProvider typePAC IDDetails
I20040416000854 GA Practitioner - Anesthesiology 0648265967 Reassigns benefits to 6 organizations
I20250825001963 MA Practitioner - Anesthesiology 0648265967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical University of South Carolina College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians

Practice addresses (Care Compare)

126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 924-6011

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027684GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Mar 16, 2016 Accepting new patients
Sentry Anesthesia Management, LLC Anesthesiology CurrentSince Jul 28, 2021 Accepting new patients
Umass Memorial Medical Group Inc Anesthesiology CurrentSince Sep 1, 2025 Accepting new patients
Gi Anesthesia of Georgia LLC Anesthesiology CurrentSince May 7, 2022 Accepting new patients
SE Georgia Anesthesia, LLC Anesthesiology CurrentSince Dec 11, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Coastal Ambulatory Anesthesia LLC Anesthesiology CurrentSince May 13, 2022 Accepting new patients
Anesthesia Consultants of Savannah, PC Anesthesiology CurrentSince Sep 1, 2021 Accepting new patients
Lighthouse Anesthesia LLC Anesthesiology PastSince May 1, 2010 Accepting new patients
Anesthesia Network Services, LLC Anesthesiology Past Accepting new patients
Alta Anesthesia Associates of Georgia, PC Anesthesiology PastSince Nov 11, 2012 Accepting new patients
Anesthesia of Coastal Georgia LLC Anesthesiology Past Accepting new patients

Locations

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

13040 Abercorn St
Ste 2
Savannah, GA 31419
Phone (912) 920-1998

8 Stephenson Ave
Savannah, GA 31405
Phone (912) 354-2479

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

519 Stephenson Ave
Savannah, GA 31405

230 E Derenne Ave
Savannah, GA 31405
Phone (912) 790-4000

4425 Paulsen St
Fl 2
Savannah, GA 31405
Phone (912) 350-2820

1139 Lexington Ave
Ste B
Savannah, GA 31404
Phone (912) 303-4200

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 12

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 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1841215902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6605 ABERCORN ST",
            "address_2": "SUITE 108",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055815",
            "telephone_number": "912-355-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 ABERCORN ST",
            "address_2": "SUITE 108",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055815",
            "telephone_number": "912-355-7214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-856-3271",
            "fax_number": "508-856-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TIMOTHY",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "1024734",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "027684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.