John K Wallace, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

00013178 Issued in AL

Practice address

2664 Hartford Hwy
Dothan, AL 36305-4904

Phone

(334) 699-2244

Fax

(334) 699-2245

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

Yes

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 FL, AL2 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

Specialty

Ophthalmology

Education

University of Mississippi School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Surgical Associates P CGroup PAC ID 5597814525, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flowers Hospital Hospital, Dothan, AL, CCN 010055
• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Merit-based Incentive Payment System (MIPS)

Final score

84.92 of 100Reported as group

Quality

100

Improvement activities

40

Cost

49.74

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eye Surgical Associates P C

  • Ophthalmology Physician
  • Dothan, AL
  • NPI 1669648879

  FL

  Medicare reassignment Care Compare group NPD Authorized official
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation
• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1992735302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 HARTFORD HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054904",
            "telephone_number": "334-699-2244",
            "fax_number": "334-699-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 HARTFORD HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054904",
            "telephone_number": "334-699-2244",
            "fax_number": "334-699-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "00013178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000046695",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna M Walker
• Jaycie Walker
• Megan Marie Walker, O.D.
• Molly McGuire Walker, OTR/L
• Peyton Lane Walker I
• Jeffrey Robert Waller
• Walmart
• Steven J Walter, PA-C
• Chase Walters, D.C.
• Kara Walters, PHARMD

• Ophthalmology Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Ophthalmology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.