Michael C Wallace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD36875 Issued in TN

Practice address

7685 Winchester Rd
Memphis, TN 38125-2202

Phone

(901) 752-6963

Fax

(901) 751-5540

NPI assigned

Aug 30, 2005

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 3

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

Family Practice

Education

University of Tennessee, HSC, College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMG Family Physicians Group Foundation IncGroup PAC ID 1557508983, 21 clinicians

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Trinity Homecare & Hospice Home health agency, Cordova, TN, CCN 447407
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Merit-based Incentive Payment System (MIPS)

Final score

85.58 of 100Reported as group

Quality

74.9

Promoting interoperability

100

Improvement activities

40

Cost

77.03

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://rxedi.bmhcc.org/prd-fhir/api/FHIR/R4/
• Direct secure messaging: mwallace15116@direct.bmhcc.org
• Direct secure messaging: mwallace31131@mlh.direct-ci.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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Family Medicine

  Medicare reassignment Care Compare group NPD
• BMG Family Physicians Group Foundation, Inc

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1578804142
  Medicare reassignment Care Compare group NPD
• Baptist Memorial Medical Group Inc

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD

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

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• LHCG Xciii, LLC

  • Home Health Agency
  • Cordova, TN
  • NPI 1235664921
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1932192556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7685 WINCHESTER RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252202",
            "telephone_number": "901-752-6963",
            "fax_number": "901-751-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD36875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1474033",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS, TN",
            "identifier": "4065344",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7128500",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Wallace
• Landon J Wallace, O.D.
• Lee S. Wallace, MS, RD, LDN, FADA
• Madison Wallace
• Marisha Wallace
• Robert D Wallace, MD
• Sharon Denice Wallace
• Terri Wallace, FNP
• William S Wallace, FNP
• Gwendolyn Felicia Waller-Moore, FNP

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.