DR. LACIE VICTORIA WALLACE MD
NPI 1366018012
Family Medicine in Mt Pleasant, SC

Q: What is Lacie Wallace's NPI number?

The NPI number for Lacie Wallace is 1366018012. It was assigned to this individual provider in the NPPES registry on June 2, 2021.

Q: What is Lacie Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Lacie Wallace was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 02, 2021PECOS EnrolledAccepts Medicare Assignment

1400 HOSPITAL DR, MT PLEASANT, SC 29464(843) 884-1341(843) 884-1345 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2024, Sep 20, 2021, Jun 2, 2021 (3 updates tracked since 2021).

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About Dr. Lacie Victoria Wallace Md NPPES

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

DR. LACIE VICTORIA WALLACE MD (NPI 1366018012) is an individual family medicine provider in Mt Pleasant, South Carolina, licensed in South Carolina (86050) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of Brody School Of Medicine At East Carolina University (2021).

NPPES Registry Identity

NPI1366018012

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LACIE VICTORIA WALLACECredential: MD

Location Address1400 HOSPITAL DRMt Pleasant, SC 29464-3255

Mailing AddressPo Box 751649Charlotte, NC 28275-1649 · (888) 472-0043 · Fax (843) 724-2440

Phone(843) 884-1341

Fax(843) 884-1345

Sole ProprietorNo

Medical School CMSBrody School Of Medicine At East Carolina UniversityGraduated 2021

Enumeration DateJune 2, 2021

Last NPPES UpdateSeptember 11, 20243 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2024

✔ NPI 1366018012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in SC · 86050✔ Licensed in SC · LL86050

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1400 HOSPITAL DR, Mt Pleasant, SC 29464

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Lacie Victoria Wallace Md 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 ID7719383553

PECOS Enrollment IDI20241004000221

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.

Areas of Expertise CMS Part B claims

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.

12 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Bon Secours-St Francis Xavier Hospital

Acute Care Hospitals · Charleston, SC

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420065

Location2095 Henry Tecklenburg DriveCharleston, SC 29414 · Charleston County

Emergency services Birthing friendly

Roper Hospital

Acute Care Hospitals · Charleston, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420087

Location316 Calhoun StCharleston, SC 29401 · Charleston County

Emergency services

East Cooper Medical Center

Acute Care Hospitals · Mount Pleasant, SC

5/5 CMS rating

OwnershipProprietary

CMS Certification Number420089

Location2000 Hospital DrMount Pleasant, SC 29464 · Charleston County

Emergency services Birthing friendly

Mount Pleasant Hospital

Acute Care Hospitals · Mount Pleasant, SC

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420104

Location3510 Highway 17 North Suite 140Mount Pleasant, SC 29466 · Charleston County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29464 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

Other Providers at the Same Location NPPES 13

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

KATHERINE RUIZ PA-C

Physician Assistant (Medical)

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 884-1341

VINITHA NAREDDY M.D.

Family Medicine

1400 HOSPITAL DR
MOUNT PLEASANT, SC 29464

Charleston County (843) 884-1341

KIMBERLY R WRIGHT FNP

Nurse Practitioner (Family)

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 884-1341

ROPER SAINT FRANCIS PHYSICIANS NETWORK

Obstetrics & Gynecology

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 884-0301

DR. DELINDA H. TERRY M.D.

Obstetrics & Gynecology

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 884-0301

ROPER SAINT FRANCIS PHYSICIANS NETWORK

Thoracic Surgery (Cardiothoracic Vascular Surgery)

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 720-8317

DR. RICHARD TRAVIS WILKES M.D.

Family Medicine

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 881-1341

MOUNT PLEASANT OB/GYN, PA

Specialist

1400 HOSPITAL DR
MT PLEASANT, SC 29464

Charleston County (843) 884-0301

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 Lacie Wallace's NPI number?

The NPI number for Lacie Wallace is 1366018012. It was assigned to this individual provider in the NPPES registry on June 2, 2021.

Where is Lacie Wallace located?

Lacie Wallace practices at 1400 Hospital Dr, Mt Pleasant, SC 29464. The listed phone number is (843) 884-1341.

What is Lacie Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lacie Wallace enrolled in Medicare?

Yes. Lacie 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.

What insurance does Lacie Wallace accept?

Health plans from First Choice Next list Lacie 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.

Is Lacie Wallace affiliated with any hospitals?

According to CMS data, Lacie Wallace is affiliated with Musc Medical Center, Bon Secours-St Francis Xavier Hospital, Roper Hospital, East Cooper Medical Center and Mount Pleasant Hospital.

When was this NPI record last updated?

The NPPES record for Lacie Wallace was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.