KELLIE L WALLACE-WILDING MD
NPI 1063518629
Family Medicine in Jackson, TN

Active since September 14, 2006PECOS EnrolledAccepts Medicare Assignment
92.69/100
CMS Quality Rating
2863 HIGHWAY 45 BYP, JACKSON, TN 38305(731) 664-1375(731) 664-1378 Get Directions Write a Review

NPPES record last updated: November 29, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kellie L Wallace-wilding Md NPPES

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

KELLIE L WALLACE-WILDING MD (NPI 1063518629) is an individual family medicine provider in Jackson, Tennessee, licensed in Tennessee (41583) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1063518629
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKELLIE L WALLACE-WILDINGCredential: MD
Location Address2863 HIGHWAY 45 BYPJackson, TN 38305-3618
Mailing AddressPo Box 400Jackson, TN 38302-0400 · (731) 423-8697 · Fax (731) 422-5743
Fax(731) 664-1378
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateSeptember 14, 2006
Last NPPES UpdateNovember 29, 2012
NPI 1063518629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TN · 41583
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2863 HIGHWAY 45 BYP, Jackson, TN 38305

Other Identifiers 3

Medicare PINP00634105TN
Medicaid3827516TN
Medicare PIN3827516TN

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kellie L Wallace-wilding Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971504457
PECOS Enrollment IDI20070125000551
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.

Areas of Expertise CMS Part B claims 62

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
2,810 services29 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
1,860 services21 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
770 services412 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
732 services411 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
638 services361 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
637 services393 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson-Madison County General Hospital

Acute Care Hospitals · Jackson, TN
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440002
Location620 Skyline DriveJackson, TN 38301 · Madison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38305 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.39
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 28

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
24 suppliers93 claims202 services$6.27 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
1 supplier14 claims14 services$2.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
19 suppliers54 claims72 services$1.12 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers30 claims30 services$95.23 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
6 suppliers39 claims94 services$34.59 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers24 claims24 services$58.64 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Nurse Practitioner (Family)
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Pediatrics
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Family Medicine
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Nurse Practitioner (Family)
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Psychologist (Clinical Child & Adolescent)
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Pediatrics
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Internal Medicine
2863 HIGHWAY 45 BYP
JACKSON, TN 38305
Advanced Practice Midwife
2863 HIGHWAY 45 BYP
JACKSON, TN 38305

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellie Wallace-wilding's NPI number?

The NPI number for Kellie Wallace-wilding is 1063518629. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Kellie Wallace-wilding located?

Kellie Wallace-wilding practices at 2863 Highway 45 Byp, Jackson, TN 38305. The listed phone number is (731) 664-1375.

What is Kellie Wallace-wilding's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kellie Wallace-wilding enrolled in Medicare?

Yes. Kellie Wallace-wilding is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kellie Wallace-wilding accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Kellie Wallace-wilding as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kellie Wallace-wilding affiliated with any hospitals?

According to CMS data, Kellie Wallace-wilding is affiliated with Jackson-Madison County General Hospital.

When was this NPI record last updated?

The NPPES record for Kellie Wallace-wilding was last updated on November 29, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.