WALLACE URGENT CARE LLC
NPI 1841259025
Internal Medicine in Wallace, NC
About Wallace Urgent Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WALLACE URGENT CARE LLC (NPI 1841259025) is a healthcare organization registered as an internal medicine in Wallace, North Carolina and active in the NPI registry since March 2006. The organization holds a CLIA Microscopy certificate valid through October 20, 2028 and lists Kamran Goudarzi, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Wallace Urgent Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Wallace Urgent Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D0951691
Wallace Urgent Care, LLC · Wallace, NCFrequently 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 Wallace Urgent Care LLC's NPI number?
The NPI number for Wallace Urgent Care LLC is 1841259025. It was assigned to this organization in the NPPES registry on March 17, 2006.
Where is Wallace Urgent Care LLC located?
Wallace Urgent Care LLC is located at 112 Medical Village Dr Unit F, Wallace, NC 28466. The listed phone number is (910) 552-1580.
What is Wallace Urgent Care LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Wallace Urgent Care LLC enrolled in Medicare?
Yes. Wallace Urgent Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Wallace Urgent Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Wallace Urgent Care LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (5) and Internal Medicine (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Wallace Urgent Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D0951691) is associated with this NPI, valid through October 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wallace Urgent Care LLC accept?
Health plans from Blue Cross and Blue Shield of NC list Wallace Urgent Care LLC 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 Wallace Urgent Care LLC was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Wallace Urgent Care Llc · NPI 1841259025
Internal Medicine organization in Wallace, North Carolina. Organization record, active in the CMS NPPES registry since March 17, 2006.
## Identity
- **NPI:** 1841259025 (Entity type: Organization)
- **Enumerated:** March 17, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Kamran Goudarzi, OWNER
## Practice location
- **Address:** 112 MEDICAL VILLAGE DR, UNIT F, Wallace, NC 28466-9999
- **Phone:** (910) 552-1580 · **Fax:** (910) 665-1780
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Internal Medicine (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 24, 2025
- **Other identifiers:** Other 01736 (NC); Medicaid 7901736 (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1841259025) · Data from the CMS NPPES public registry.