Heather Elizabeth Gordon Wallace, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21745 Issued in SC

Practice address

1879 Savage Rd
Charleston, SC 29407-4726

Phone

(843) 763-9472

Fax

(843) 763-7411

NPI assigned

May 29, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027
• Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
• Roper Hospital Hospital, Charleston, SC, CCN 420087
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hwallace1252712@direct.bsmhealth.org

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.

• Roper Saint Francis Physicians Network

  • Surgery Physician
  • Charleston, SC
  • NPI 1124431606
  Medicare reassignment Care Compare group NPD
• Roper Saint Francis Physicians Network

  • Surgery Physician
  • Charleston, SC
  • NPI 1013480318
  NPD
• Roper Saint Francis Physicians Network

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1811857352
  NPD

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

• Amedisys SC, LLC

  • Home Health Agency
  • Charleston, SC
  • NPI 1447218748
  Care Compare affiliation
• Bon Secours St. Francis Xavier Hospital Inc.

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation
• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1962993634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 SAVAGE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "843-763-9472",
            "fax_number": "843-763-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH GORDON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5266",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Wallace
• Ansleigh Morrow Wallace, FNP-BC
• Charles T Wallace, MD
• Charlotte Wallace, M.D.
• Debra J Wallace, LISW
• Katherine Wallace, LISW-CP, MPH
• Kennede Marissa Wallace, PHARMD
• Megan Wallace, LMSW
• Micah Jordan Wallace, PHARM.D.
• Victoria Catherine Wallace

• Family Nurse Practitioner in Charleston, SC
• Providers in Charleston, 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 Mar 30, 2026; 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.