AMY JO WALLACE MD
NPI 1467487322
Pediatrics in Kernersville, NC

Active since July 11, 2006PECOS Enrolled
861 OLD WINSTON RD STE 101, KERNERSVILLE, NC 27284(336) 904-0143(336) 904-0046 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 4, 2020, Feb 3, 2017 (2 updates tracked since 2017).

About Amy Jo Wallace Md NPPES

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

AMY JO WALLACE MD (NPI 1467487322) is an individual pediatrics provider in Kernersville, North Carolina, licensed in North Carolina (200600865) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Kernersville.

NPPES Registry Identity

NPI1467487322
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameAMY JO WALLACECredential: MD
Location Address861 OLD WINSTON RD STE 101Kernersville, NC 27284-7141
Mailing AddressPo Box 602658Charlotte, NC 28260-2658 · (336) 716-2011
Fax(336) 904-0046
Sole ProprietorNo
Enumeration DateJuly 11, 2006
Last NPPES UpdateNovember 4, 20202 updates tracked since enumeration
NPPES CertifiedNovember 4, 2020
NPI 1467487322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses Licensed in NC · 200600865 Licensed in SC · 26169
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

861 OLD WINSTON RD STE 101, Kernersville, NC 27284

Secondary Practice Location 1

Location 1815 Old Winston RdKernersville, NC 27284-7124 · Phone (336) 713-0990

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Amy Jo Wallace Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27284 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 5

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

Nurse Practitioner (Family)
861 OLD WINSTON RD STE 101
KERNERSVILLE, NC 27284
Pediatrics
861 OLD WINSTON RD STE 101
KERNERSVILLE, NC 27284
Internal Medicine
861 OLD WINSTON RD STE 101
KERNERSVILLE, NC 27284
Family Medicine
861 OLD WINSTON RD STE 101
KERNERSVILLE, NC 27284
Internal Medicine
861 OLD WINSTON RD STE 101
KERNERSVILLE, NC 27284

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 Amy Jo Wallace's NPI number?

The NPI number for Amy Jo Wallace is 1467487322. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Amy Jo Wallace located?

Amy Jo Wallace practices at 861 Old Winston Rd Ste 101, Kernersville, NC 27284. The listed phone number is (336) 904-0143.

What is Amy Jo Wallace's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Amy Jo Wallace enrolled in Medicare?

Yes. Amy Jo Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Amy Jo Wallace accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 2 other insurers list Amy Jo 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 Amy Jo Wallace was last updated on November 4, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.