HEATHER E WALLACE
NPI 1053856427
Nurse Practitioner - Gerontology in Macon, GA

NPI Status: Active since December 21, 2016

Contact Information

535 COLISEUM DR
MACON, GA
ZIP 31217
Phone: (478) 972-0277

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Nurse Practitioner
Gerontology
Accepts Insurance
PECOS Enrolled

About HEATHER WALLACE

This page provides the complete NPI Profile along with additional information for Heather Wallace, a provider established in Macon, Georgia with a medical specialization in Nurse Practitioner, focusing in gerontology . The healthcare provider is registered in the NPI registry with number 1053856427 assigned on December 2016. The practitioner's primary taxonomy code is 363LG0600X with license number RN197918 (GA). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI: 1053856427
Provider Name: HEATHER E WALLACE
Gender: Female
Entity Type: Individual
Location Address: 535 COLISEUM DR MACON, GA 31217
Location Phone: (478) 972-0277
Mailing Address: PO BOX 26698 MACON, GA 31221
Mailing Phone: (478) 972-0277
Is Sole Proprietor?: No
Enumeration Date: 12-21-2016
Last Update Date: 12-27-2016
Code Navigator

A nurse practitioner (NP) like Heather Wallace is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Practitioner Gerontology
Taxonomy Code: 363LG0600X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: RN197918
License State: GA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	RN197918 (GA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Alliant Health Plans, Inc.

SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
SoloCare Gold EPO $1500 DED 10010 - EPO
SoloCare Silver EPO $5000 DED 10014 - EPO
SoloCare Silver EPO $6500 DED 10013 - EPO
SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
SoloCare Standard Gold EPO $2000 DED 10006 - EPO
SoloCare Standard Platinum EPO $0 DED 10005 - EPO
SoloCare Standard Silver EPO $6000 DED 10007 - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Heather Wallace is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 31217 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $83.23
Minimum New Patient Price $53.31
Maximum New Patient Price $164.04

Average New Patient Copayment $20.8
Minimum New Patient Copayment $13.32
Maximum New Patient Copayment $41.01

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $94.84
Minimum Established Patient Price $16.68
Maximum Established Patient Price $133.24

Average Established Patient Copayment $23.71
Minimum Established Patient Copayment $4.17
Maximum Established Patient Copayment $33.31

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053856427, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 16 → 1 + 6

Pos 6

Unchanged

Pos 7

Doubled → 12 → 1 + 2

Pos 8

Unchanged

Pos 9

Doubled → 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 8 → 16 → 7 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 1 + 6 + 5 + 1 + 2 + 4 + 4 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1053856427.