DAVID C. WALLACE
NPI 1952604183
Counselor - Professional in Columbus, GA

Active since December 09, 2010PECOS Enrolled
2100 COMER AVE, COLUMBUS, GA 31904(706) 323-0174(706) 256-3264 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About David C. Wallace NPPES

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

DAVID C. WALLACE (NPI 1952604183) is an individual professional provider in Columbus, Georgia, licensed in Georgia (LPC004754) and active in the NPI registry since December 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952604183
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDAVID C. WALLACE
Location Address2100 COMER AVEColumbus, GA 31904-8725
Mailing Address5700 Veterans PkwyColumbus, GA 31904-9093 · (706) 221-3222 · Fax (706) 221-3282
Fax(706) 256-3264
Sole ProprietorNo
Enumeration DateDecember 9, 2010
Last NPPES UpdateOctober 10, 2023
NPPES CertifiedOctober 10, 2023
✔ NPI 1952604183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC004754
2100 COMER AVE, Columbus, GA 31904

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David C. Wallace 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.

Medicare Billing Reassignment

Medicare enrollment records show David Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychiatry
6003 VETERANS PKWY
Columbus, GA 31909
  • Reassigned Medicare billing, Georgia enrollment
  • 39 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Social Worker
2100 COMER AVE
COLUMBUS, GA 31904
Community Health Worker
2100 COMER AVE
COLUMBUS, GA 31904
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
2100 COMER AVE
COLUMBUS, GA 31904
Social Worker
2100 COMER AVE
COLUMBUS, GA 31904
Case Manager/Care Coordinator
2100 COMER AVE
COLUMBUS, GA 31904
Licensed Practical Nurse
2100 COMER AVE
COLUMBUS, GA 31904
Licensed Practical Nurse
2100 COMER AVE
COLUMBUS, GA 31904
Clinic/Center
2100 COMER AVE
COLUMBUS, GA 31904

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 David Wallace's NPI number?

The NPI number for David Wallace is 1952604183. It was assigned to this individual provider in the NPPES registry on December 9, 2010.

Where is David Wallace located?

David Wallace practices at 2100 Comer Ave, Columbus, GA 31904. The listed phone number is (706) 323-0174.

What is David Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is David Wallace enrolled in Medicare?

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

Which organization bills Medicare for David Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Wallace reassigns Medicare benefits to Rivertown Psychiatry, PC (Columbus, GA). The 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 David Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for David Wallace was last updated on October 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.