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JAMES JEFFERSON WALLACE III MD
NPI 1306067954
Psychiatry & Neurology - Psychiatry in Martinez, GA

Active since May 01, 2007Opted out of Medicare · through Jan 29, 2027
4143 COLUMBIA RD, SUITE D, MARTINEZ, GA 30907(706) 651-1299(706) 651-1145 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About James Jefferson Wallace Iii Md NPPES

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

JAMES JEFFERSON WALLACE III MD (NPI 1306067954) is an individual psychiatry provider in Martinez, Georgia, licensed in Georgia (024369) and active in the NPI registry since May 2007. He has opted out of Medicare through January 29, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1306067954
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJAMES JEFFERSON WALLACE IIICredential: MD
Location Address4143 COLUMBIA RD, SUITE DMartinez, GA 30907
Mailing Address4143 Columbia Rd, Suite DMartinez, GA 30907 · (706) 651-1299 · Fax (706) 651-1145
Phone(706) 651-1299
Fax(706) 651-1145
Sole ProprietorYes
Enumeration DateMay 1, 2007
Last NPPES UpdateJune 12, 2024
NPPES CertifiedJune 12, 2024
✔ NPI 1306067954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in GA · 024369
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
4143 COLUMBIA RD, Martinez, GA 30907
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

James Jefferson Wallace Iii Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 29, 2021 through January 29, 2027.

Opt-Out Effective DateJanuary 29, 2021
Opt-Out In Effect ThroughJanuary 29, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30907 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
$164.04 typical visit price
range $53.31 – $164.04
Typical copayment $41.01 (range $13.32 – $41.01)
Most-billed visit code 99205
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SAMANTHA NICOLE SCALA RBT
Behavior Technician
4143 COLUMBIA RD
MARTINEZ, GA 30907
Columbia County (706) 755-2785
SARAH RUTH ROSS
Behavior Technician
4143 COLUMBIA RD
MARTINEZ, GA 30907
Columbia County (706) 755-2785
MRS. DONNA H LEWIS LCSW
Social Worker (Clinical)
4143 COLUMBIA RD, SUITE D
MARTINEZ, GA 30907
Columbia County (706) 651-1299

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 James Wallace's NPI number?

The NPI number for James Wallace is 1306067954. It was assigned to this individual provider in the NPPES registry on May 1, 2007.

Where is James Wallace located?

James Wallace practices at 4143 Columbia Rd Suite D, Martinez, GA 30907. The listed phone number is (706) 651-1299.

What is James Wallace's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is James Wallace enrolled in Medicare?

No. James Wallace has opted out of Medicare through January 29, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for James Wallace was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.