JOHN GRAY WALLACE M.D.
NPI 1831486596
Family Medicine in Kosciusko, MS

Active since July 01, 2011PECOS EnrolledAccepts Medicare Assignment
332 HIGHWAY 12 W, KOSCIUSKO, MS 39090(662) 289-1800(662) 289-2486 Get Directions Write a Review

NPPES record last updated: September 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About John Gray Wallace M.d. NPPES

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

JOHN GRAY WALLACE M.D. (NPI 1831486596) is an individual family medicine provider in Kosciusko, Mississippi, licensed in Mississippi (22522) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Mississippi Baptist Medical Center, and is a graduate of University Of Mississippi School Of Medicine (2011).

NPPES Registry Identity

NPI1831486596
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOHN GRAY WALLACECredential: M.D.
Location Address332 HIGHWAY 12 WKosciusko, MS 39090-3209
Mailing AddressPo Box 23996Jackson, MS 39225-3996 · (601) 206-6100 · Fax (601) 206-6052
Fax(662) 289-2486
Sole ProprietorNo
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 2011
Enumeration DateJuly 1, 2011
Last NPPES UpdateSeptember 22, 2014
NPI 1831486596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in MS · 22522
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.
332 HIGHWAY 12 W, Kosciusko, MS 39090

Other Identifiers 1

Medicaid07830815MS

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 and accepts Medicare assignment

John Gray Wallace M.d. 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 ID3072756808
PECOS Enrollment IDI20130827000525
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 70

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.

Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
3,840 services40 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
3,490 services27 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.
1,257 services467 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
786 services371 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
597 services360 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
528 services93 patients

Hospital Affiliations CMS Care Compare 2

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

Mississippi Baptist Medical Center

Acute Care Hospitals · Jackson, MS
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number250102
Location1225 N State StJackson, MS 39202 · Hinds County
Emergency services Birthing friendly

Baptist Medical Center Attala

Critical Access Hospitals · Kosciusko, MS
OwnershipVoluntary non-profit - Other
CMS Certification Number251336
Location220 Hwy 12 WestKosciusko, MS 39090 · Attala County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39090 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

Referred Medical Equipment & Supplies CMS DME claims 14

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers30 claims92 services$6.74 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers17 claims28 services$1.08 avg. paid by Medicare
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$20.85 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers14 claims25 services$1.80 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers31 claims31 services$65.34 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers51 claims51 services$18.74 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

Family Medicine
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Family Medicine
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Social Worker (Clinical)
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Neurological Surgery
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Radiology (Diagnostic Radiology)
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Family Medicine
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Family Medicine
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090
Family Medicine
332 HIGHWAY 12 W
KOSCIUSKO, MS 39090

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 John Wallace's NPI number?

The NPI number for John Wallace is 1831486596. It was assigned to this individual provider in the NPPES registry on July 1, 2011.

Where is John Wallace located?

John Wallace practices at 332 Highway 12 W, Kosciusko, MS 39090. The listed phone number is (662) 289-1800.

What is John Wallace's specialty?

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

Is John Wallace enrolled in Medicare?

Yes. John 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 John Wallace accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list John 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 John Wallace affiliated with any hospitals?

According to CMS data, John Wallace is affiliated with Mississippi Baptist Medical Center and Baptist Medical Center Attala.

When was this NPI record last updated?

The NPPES record for John Wallace was last updated on September 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.