1. Home
  2. Directory
  3. Georgia
  4. Conyers
  5. Nurse Practitioner
  6. NPI Profile

MARLYN M. WALLACE
NPI 1144790973
Nurse Practitioner in Conyers, GA

Active since December 05, 2018PECOS EnrolledAccepts Medicare Assignment
3073 KLONDIKE RD SW, CONYERS, GA 30094(678) 558-3106 Get Directions Write a Review

NPPES record last updated: December 5, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Marlyn M. Wallace NPPES

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

MARLYN M. WALLACE (NPI 1144790973) is an individual nurse practitioner in Conyers, Georgia, licensed in Georgia (RN182038) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1144790973
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMARLYN M. WALLACE
Location Address3073 KLONDIKE RD SWConyers, GA 30094-5660
Mailing Address3073 Klondike Rd SwConyers, GA 30094-5660 · (678) 558-3106
Phone(678) 558-3106
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateDecember 5, 2018
✔ NPI 1144790973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN182038
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
3073 KLONDIKE RD SW, Conyers, GA 30094
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marlyn M. Wallace 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 ID6608102884
PECOS Enrollment IDI20190725001697
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Marlyn Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Atlanta Plus Primary Care LLC
6.4 mi
Internal Medicine
2121 SALEM RD SE
Conyers, GA 30013
  • Reassigned Medicare billing, Georgia enrollment
  • 14 clinicians in this Medicare group
NPI 1265144414 (470) 826-4051
Atlanta Plus Urgent Care
6.4 mi
Urgent Care
2121 SALEM RD. SE
Conyers, GA 30013
  • Reassigned Medicare billing, Georgia enrollment
  • 19 clinicians in this Medicare group
NPI 1588163638 (770) 679-4360

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.

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.
55 services44 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
41 services34 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
35 services29 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
23 services23 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
17 services16 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30094 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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 Marlyn Wallace's NPI number?

The NPI number for Marlyn Wallace is 1144790973. It was assigned to this individual provider in the NPPES registry on December 5, 2018.

Where is Marlyn Wallace located?

Marlyn Wallace practices at 3073 Klondike Rd SW, Conyers, GA 30094. The listed phone number is (678) 558-3106.

What is Marlyn Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Marlyn Wallace enrolled in Medicare?

Yes. Marlyn Wallace 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.

Which organizations bill Medicare for Marlyn Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marlyn Wallace reassigns Medicare benefits to 2 organizations: Atlanta Plus Primary Care LLC (Conyers, GA) and Atlanta Plus Urgent Care (Conyers, GA). Each 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 Marlyn Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marlyn Wallace accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Marlyn 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 Marlyn Wallace was last updated on December 5, 2018. 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.