MR. LAWRENCE WALLACE MD, PT
NPI 1679567192
Physical Therapist in North Myrtle Beach, SC
About Mr. Lawrence Wallace Md, Pt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. LAWRENCE WALLACE MD, PT (NPI 1679567192) is an individual physical therapist in North Myrtle Beach, South Carolina, licensed in South Carolina (11194) and active in the NPI registry since September 2005. He is a graduate of Other (1997).
NPPES Registry Identity
Specialties & Licenses 2
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Other Identifiers 1
Accepted 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
Mr. Lawrence Wallace Md, Pt 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.
Medicare Billing Reassignment
Medicare enrollment records show Lawrence Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North Myrtle Beach, SC 29582
- Reassigned Medicare billing, South Carolina enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29582 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
NORTH MYRTLE BEACH, SC 29582
NORTH MYRTLE BEACH, SC 29582
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 Lawrence Wallace's NPI number?
The NPI number for Lawrence Wallace is 1679567192. It was assigned to this individual provider in the NPPES registry on September 12, 2005.
Where is Lawrence Wallace located?
Lawrence Wallace practices at 1021 2nd Ave N Ste 6, North Myrtle Beach, SC 29582. The listed phone number is (843) 286-5168.
What is Lawrence Wallace's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Lawrence Wallace enrolled in Medicare?
Yes. Lawrence 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 organization bills Medicare for Lawrence Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lawrence Wallace reassigns Medicare benefits to Elite Hand And Upper Extremity Therapy (North Myrtle Beach, SC). The 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 Lawrence Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lawrence Wallace accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and Molina Healthcare list Lawrence 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 Lawrence Wallace was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Mr. Lawrence Wallace, MD, PT · NPI 1679567192
Physical Therapist provider in North Myrtle Beach, South Carolina. Individual provider, active in the CMS NPPES registry since September 12, 2005.
## Identity
- **NPI:** 1679567192 (Entity type: Individual)
- **Enumerated:** September 12, 2005
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** 11194 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 1021 2ND AVE N STE 6, North Myrtle Beach, SC 29582-3200
- **Phone:** (843) 286-5168 · **Fax:** (844) 318-8980
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Elite Hand And Upper Extremity Therapy (NPI 1467086926, North Myrtle Beach, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1997
## Record status
- **NPPES last updated:** January 26, 2026
- **Other identifiers:** Medicaid 010114446 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1679567192) · Data from the CMS NPPES public registry.