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WALLACE PHYSICIAN SERVICES LLC
NPI 1144527870
Internal Medicine in Cincinnati, OH

Active since February 15, 2011CLIA 36D2193798 · Waiver
1577 GOODMAN AVE STE A, CINCINNATI, OH 45224(513) 403-3762(513) 521-6403 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018 (2 updates tracked since 2018).

About Wallace Physician Services Llc NPPES

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

WALLACE PHYSICIAN SERVICES LLC (NPI 1144527870) is a healthcare organization registered as an internal medicine in Cincinnati, Ohio and active in the NPI registry since February 2011. The organization holds a CLIA Waiver certificate valid through September 23, 2026, maintains a secondary practice location in Cincinnati, and lists Waymon L Wallace, President, as its authorized official.

NPPES Registry Identity

NPI1144527870
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWALLACE PHYSICIAN SERVICES LLC
Location Address1577 GOODMAN AVE STE ACincinnati, OH 45224-1044
Mailing AddressPo Box 40535Cincinnati, OH 45240-0535 · (859) 384-9045 · Fax (859) 212-0949
Phone(513) 403-3762
Fax(513) 521-6403
Organization SubpartNo
Authorized OfficialWaymon L WallacePresident · (513) 674-9601
Enumeration DateFebruary 15, 2011
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1144527870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35-076674
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1577 GOODMAN AVE STE A, Cincinnati, OH 45224
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Secondary Practice Location 1

Location 111414 Odessa CtCincinnati, OH 45240-2847 · Phone (859) 384-9045 · Fax (859) 212-0949

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2193798

Wallace Physician Services · Cincinnati, OH
Active · expires Sep 23, 2026
CLIA Number36D2193798
Laboratory TypePhysician Office
Certificate Effective DateSeptember 24, 2024
Certificate Expiration DateSeptember 23, 2026
Laboratory DirectorWaymon Wallace
Laboratory Phone(513) 521-3800
Laboratory LocationWallace Physician Services1577A Goodman Ave, Cincinnati, OH 45224
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

NORTH COLLEGE HILL INTERNAL
Internal Medicine
1577 GOODMAN AVE STE A
CINCINNATI, OH 45224
Hamilton County (513) 521-3600
JACQUELINE MARIE SCHMIDT MSN, APRN, FNP-BC
Nurse Practitioner (Family)
1577 GOODMAN AVE STE A
CINCINNATI, OH 45224
Hamilton County (513) 521-3600
WAYMON L WALLACE MD
Internal Medicine
1577 GOODMAN AVE STE A
CINCINNATI, OH 45224
Hamilton County (513) 403-3762

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 Wallace Physician Services LLC's NPI number?

The NPI number for Wallace Physician Services LLC is 1144527870. It was assigned to this organization in the NPPES registry on February 15, 2011.

Where is Wallace Physician Services LLC located?

Wallace Physician Services LLC is located at 1577 Goodman Ave Ste A, Cincinnati, OH 45224. The listed phone number is (513) 403-3762.

What is Wallace Physician Services LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Wallace Physician Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2193798) is associated with this NPI, valid through September 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wallace Physician Services LLC accept?

Health plans from Molina Healthcare list Wallace Physician Services LLC 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 Wallace Physician Services LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.