MARY MARGARET WALLACH RD, LD
NPI 1124517941
Dietitian, Registered in Greenville, SC
About Mary Margaret Wallach Rd, Ld NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY MARGARET WALLACH RD, LD (NPI 1124517941) is an individual dietitian, registered in Greenville, South Carolina, licensed in South Carolina (1746) and active in the NPI registry since May 2018.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Margaret Wallach Rd, Ld is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Wallach reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Greenville, SC 29607
- Reassigned Medicare billing, South Carolina enrollment
- 3,281 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Mary Wallach's NPI number?
The NPI number for Mary Wallach is 1124517941. It was assigned to this individual provider in the NPPES registry on May 7, 2018.
Where is Mary Wallach located?
Mary Wallach practices at 905 Verdae Blvd Ste 103, Greenville, SC 29607. The listed phone number is (864) 522-2186.
What is Mary Wallach's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Mary Wallach enrolled in Medicare?
Yes. Mary Wallach is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Wallach's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Wallach reassigns Medicare benefits to Prisma Health University Medical Group (Greenville, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Wallach's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Wallach was last updated on May 8, 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.
# Mary Margaret Wallach, RD, LD · NPI 1124517941
Dietitian, Registered provider in Greenville, South Carolina. Individual provider, active in the CMS NPPES registry since May 7, 2018.
## Identity
- **NPI:** 1124517941 (Entity type: Individual)
- **Enumerated:** May 7, 2018
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **State license:** 1746 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 905 VERDAE BLVD STE 103, Greenville, SC 29607-4029
- **Phone:** (864) 522-2186
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Prisma Health University Medical Group (NPI 1083787006, Greenville, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2019
---
Source: [NPI Profile](https://npiprofile.com/npi/1124517941) · Data from the CMS NPPES public registry.