NPIMap

Individual provider Active NPI

Christopher William Wallace

  • Internal Medicine Physician
  • Merriam, KS
National Provider Identifier
1992208706
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-44445 Issued in KS
Practice address
9100 W 74TH St
Merriam, KS 66204-4004
Phone
(913) 676-2000
NPI assigned
Mar 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 04-44445 KS Primary
Internal Medicine Physician 207R00000X 29506 WV

Addresses

Primary practice location

9100 W 74TH St
Merriam, KS 66204-4004

Mailing address

9100 W 74TH St
Merriam, KS 66204-4004
Phone (913) 676-2000

Other practice location 1

4700 Indian Creek Pkwy
Overland Park, KS 66207-4068
Phone (913) 890-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809003054 KS Practitioner - Internal Medicine 8325399363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

929 N Saint Francis Ave
HMP of TX PLLC
Wichita, KS 67214-3821
Phone (316) 291-4396

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-44445KSMDInternal Medicine Physician
29506WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Kansas PA Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Inpatient Consultants of Kansas PA Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Feb 20, 2024 Accepting new patients
Shawnee Mission Medical Center Inc Past Accepting new patients

Locations

4700 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 232-2413

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

Organizations & group practices 4

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 7

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": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1992208706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Indian Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662074068",
            "country_code": "US",
            "telephone_number": "913-890-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-18",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-44445",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

Verify at the official NPI Registry.