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MR. RICHARD JEREMY WALLACE PA-C
NPI 1841583788
Physician Assistant in Williston, SC

Active since May 25, 2011PECOS Enrolled
13649 CHURCH STREET, WILLISTON, SC 29853(803) 266-0060(803) 266-0042 Get Directions Write a Review

NPPES record last updated: January 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 8, 2023, Mar 16, 2023, Aug 2, 2022 and 4 more (7 updates tracked since 2018).

About Mr. Richard Jeremy Wallace Pa-c NPPES

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

MR. RICHARD JEREMY WALLACE PA-C (NPI 1841583788) is an individual physician assistant in Williston, South Carolina and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841583788
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. RICHARD JEREMY WALLACECredential: PA-C
Location Address13649 CHURCH STREETWilliston, SC 29853
Mailing Address86 Wren StBarnwell, SC 29812-1529 · (803) 259-5762 · Fax (803) 259-3250
Phone(803) 266-0060
Fax(803) 266-0042
Sole ProprietorNo
Enumeration DateMay 25, 2011
Last NPPES UpdateJanuary 11, 20247 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2024
✔ NPI 1841583788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
13649 CHURCH STREET, Williston, SC 29853
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Other Identifiers 3

Other2920SC · Medical License
OtherSCE705SC · Medicare
Medicaid3559PASC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Richard Jeremy Wallace Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29853 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

VICKIE GLOVER PA
Physician Assistant
13649 CHURCH STREET
WILLISTON, SC 29853
Barnwell County (803) 266-0060

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 Richard Wallace's NPI number?

The NPI number for Richard Wallace is 1841583788. It was assigned to this individual provider in the NPPES registry on May 25, 2011.

Where is Richard Wallace located?

Richard Wallace practices at 13649 Church Street, Williston, SC 29853. The listed phone number is (803) 266-0060.

What is Richard Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Richard Wallace enrolled in Medicare?

Yes. Richard Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Richard Wallace accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next list Richard 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 Richard Wallace was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.