WALLACE URGENT CARE LLC
NPI 1841259025
Internal Medicine in Wallace, NC

Active since March 17, 2006CLIA 34D0951691 · Microscopy
112 MEDICAL VILLAGE DR, UNIT F, WALLACE, NC 28466(910) 552-1580(910) 665-1780 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 24, 2025, Feb 4, 2025 (2 updates tracked since 2025).

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, 2026 and lists Kamran Goudarzi, Owner, as its authorized official.

NPPES Registry Identity

NPI1841259025
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWALLACE URGENT CARE LLC
Location Address112 MEDICAL VILLAGE DR, UNIT FWallace, NC 28466-9999
Mailing Address112 Medical Village Dr, Unit FWallace, NC 28466-9999 · (910) 552-1580 · Fax (910) 665-1780
Fax(910) 665-1780
Organization SubpartNo
Authorized OfficialKamran GoudarziOwner · (910) 552-1580
Enumeration DateMarch 17, 2006
Last NPPES UpdateJune 24, 20252 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
NPI 1841259025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
112 MEDICAL VILLAGE DR, Wallace, NC 28466

Other Identifiers 2

Other01736NC · Ncbcbs Provider Number
Medicaid7901736NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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, NC
Active · expires Oct 20, 2026
CLIA Number34D0951691
Laboratory TypeUrgent Care
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorDaniel M. Ricci
Laboratory Phone(910) 552-1580
Laboratory LocationWallace Urgent Care, LLC112 Medical Village Drive, Unit G, Wallace, NC 28466
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

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

Internal Medicine
112 MEDICAL VILLAGE DR, UNIT F
WALLACE, NC 28466
Family Medicine
112 MEDICAL VILLAGE DR, UNIT D
WALLACE, NC 28466
Physical Therapist
112 MEDICAL VILLAGE DR
WALLACE, NC 28466
Family Medicine
112 MEDICAL VILLAGE DR
WALLACE, NC 28466
Chiropractor
112 MEDICAL VILLAGE DR, SUITE A
WALLACE, NC 28466
Physician Assistant
112 MEDICAL VILLAGE DR, SUITE G
WALLACE, NC 28466
Family Medicine
112 MEDICAL VILLAGE DR, STE G
WALLACE, NC 28466
Family Medicine
112 MEDICAL VILLAGE DR, UNIT D
WALLACE, NC 28466

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 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.

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, 2026. 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 with the weekly NPPES data releases published by CMS.