LODICA WALLACE
NPI 1114587557
Nurse Practitioner - Family in Commerce Twp, MI

Q: What is Lodica Wallace's NPI number?

The NPI number for Lodica Wallace is 1114587557. It was assigned to this individual provider in the NPPES registry on June 18, 2019.

Q: What is Lodica Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lodica Wallace was last updated on June 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 18, 2019PECOS Enrolled

790 DRAKESHIRE DR, COMMERCE TWP, MI 48390(248) 910-2762 Get Directions Write a Review

NPPES record last updated: June 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lodica Wallace NPPES

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

LODICA WALLACE (NPI 1114587557) is an individual family provider in Commerce Twp, Michigan, licensed in Michigan (2018023394) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114587557

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLODICA WALLACE

Location Address790 DRAKESHIRE DRCommerce Twp, MI 48390-2981

Mailing Address790 Drakeshire DrCommerce Twp, MI 48390-2981

Phone(248) 910-2762

Sole ProprietorYes

Enumeration DateJune 18, 2019

✔ NPI 1114587557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in MI · 2018023394

790 DRAKESHIRE DR, Commerce Twp, MI 48390

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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)

Lodica 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 48390 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

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 Lodica Wallace's NPI number?

The NPI number for Lodica Wallace is 1114587557. It was assigned to this individual provider in the NPPES registry on June 18, 2019.

Where is Lodica Wallace located?

Lodica Wallace practices at 790 Drakeshire Dr, Commerce Twp, MI 48390. The listed phone number is (248) 910-2762.

What is Lodica Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lodica Wallace enrolled in Medicare?

Yes. Lodica Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Lodica Wallace accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Lodica Wallace 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.

When was this NPI record last updated?

The NPPES record for Lodica Wallace was last updated on June 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.