Wallace Earl Holland Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

024438 Issued in GA

Practice address

10055 Ford Ave
Suite 5a
Richmond Hill, GA 31324-3972

Phone

(912) 756-2020

Fax

(912) 756-3187

NPI assigned

Jul 14, 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 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Internal Medicine

Education

Medical University of South Carolina College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Savannah, GA, CCN 117078
• Candler Hospital Hospital, Savannah, GA, CCN 110024
• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: wallacehollandjr@scmgllc.allscriptsdirect.net
• Direct secure messaging: wallace.holland.1@8042.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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857

  GA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273

  Internal Medicine

  NPD

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

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Savannah, GA
  • NPI 1942483920
  Care Compare affiliation
• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889

  Hospital

  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684

  Hospital

  Care Compare affiliation
• Savannah Health Services, LLC

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1972501799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10055 FORD AVE",
            "address_2": "SUITE 5A",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243972",
            "telephone_number": "912-756-2020",
            "fax_number": "912-756-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10055 FORD AVE",
            "address_2": "SUITE 5A",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243972",
            "telephone_number": "912-756-2020",
            "fax_number": "912-756-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "WALLACE",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "024438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G24438",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "681687",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Parris Hickman, DC
• Brandy Lee Hill
• Wai Yin Ho, RD
• Nathan Tyler Hodges
• Edward Morris Hoffman, M.D.
• Pamela M Holmes, LCSW
• Jeremy Holt, BCBA
• Holy Ground Ministries
• Hope ABA LLC
• Natalie A Horseman, BA, RBT

• Internal Medicine Physician in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.