KIMBERLY SHANNON WALLACE MD
NPI 1770627705
Family Medicine in Gambrills, MD

Q: What is Kimberly Wallace's NPI number?

The NPI number for Kimberly Wallace is 1770627705. It was assigned to this individual provider in the NPPES registry on February 15, 2007.

Q: What is Kimberly 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 Kimberly Wallace was last updated on March 18, 2019. 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.

Active since February 15, 2007PECOS EnrolledAccepts Medicare Assignment

20.25/100

CMS Quality Rating

1438 DEFENSE HWY SUITE 201, GAMBRILLS, MD 21054(410) 721-3200(410) 721-2680 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Kimberly Shannon Wallace Md NPPES

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

KIMBERLY SHANNON WALLACE MD (NPI 1770627705) is an individual family medicine provider in Gambrills, Maryland, licensed in Maryland (D66924) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of University Of Maryland School Of Medicine (2004).

NPPES Registry Identity

NPI1770627705

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKIMBERLY SHANNON WALLACECredential: MD

Location Address1438 DEFENSE HWY SUITE 201Gambrills, MD 21054

Mailing Address1438 Defense Hwy Suite 201Gambrills, MD 21054 · (410) 721-3200 · Fax (410) 721-2680

Phone(410) 721-3200

Fax(410) 721-2680

Sole ProprietorYes

Medical School CMSUniversity Of Maryland School Of MedicineGraduated 2004

Enumeration DateFebruary 15, 2007

Last NPPES UpdateMarch 18, 2019

✔ NPI 1770627705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MD · D66924

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.

1438 DEFENSE HWY SUITE 201, Gambrills, MD 21054

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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

Kimberly Shannon 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 ID5496937351

PECOS Enrollment IDI20130115000239

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 13

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

681 services350 patients

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.

323 services217 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

94 services94 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

56 services56 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

53 services52 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

51 services51 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

44 services44 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

40 services35 patients

Administration of vaccine 90471

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

36 services35 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.

27 services11 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

25 services24 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

17 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21054 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

$94.08 typical visit price

range $60.73 – $183.44

Typical copayment $23.52 (range $15.18 – $45.86)

Most-billed visit code 99203

Established Patient

$106.59 typical visit price

range $19.60 – $149.17

Typical copayment $26.64 (range $4.90 – $37.29)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

20.25/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Cost

67.53

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers12 claims64 services$2.00 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier11 claims11 services$5.00 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers12 claims12 services$33.13 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Kimberly Wallace's NPI number?

The NPI number for Kimberly Wallace is 1770627705. It was assigned to this individual provider in the NPPES registry on February 15, 2007.

Where is Kimberly Wallace located?

Kimberly Wallace practices at 1438 Defense Hwy Suite 201, Gambrills, MD 21054. The listed phone number is (410) 721-3200.

What is Kimberly Wallace's specialty?

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

Is Kimberly Wallace enrolled in Medicare?

Yes. Kimberly 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.

When was this NPI record last updated?

The NPPES record for Kimberly Wallace was last updated on March 18, 2019. 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.