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

Q: What is Heather Wallace's NPI number?

The NPI number for Heather Wallace is 1053856427. It was assigned to this individual provider in the NPPES registry on December 21, 2016.

Q: What is Heather Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Heather Wallace was last updated on December 27, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 21, 2016PECOS Enrolled

535 COLISEUM DR, MACON, GA 31217(478) 972-0277 Get Directions Write a Review

NPPES record last updated: December 27, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 27, 2016, Dec 21, 2016 (2 updates tracked since 2016).

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About Heather E Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHER E WALLACE (NPI 1053856427) is an individual gerontology provider in Macon, Georgia, licensed in Georgia (RN197918) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053856427

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameHEATHER E WALLACE

Location Address535 COLISEUM DRMacon, GA 31217-0104

Mailing AddressPo Box 26698Macon, GA 31221-6698 · (478) 972-0277

Phone(478) 972-0277

Sole ProprietorNo

Enumeration DateDecember 21, 2016

Last NPPES UpdateDecember 27, 20162 updates tracked since enumeration

✔ NPI 1053856427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in GA · RN197918

Also ListedNurse PractitionerTaxonomy 363L00000X · License RN197918 (GA)

535 COLISEUM DR, Macon, GA 31217

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heather E Wallace is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31217 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGENCY HOSPITAL COMPANY OF MACON LLC

Hospitalist