HEATHER ELIZABETH GORDON WALLACE FNP
NPI 1962993634
Nurse Practitioner - Family in Charleston, SC

Q: What is Heather Wallace's NPI number?

The NPI number for Heather Wallace is 1962993634. It was assigned to this individual provider in the NPPES registry on May 29, 2018.

Q: What is Heather Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Heather Wallace was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 29, 2018PECOS EnrolledAccepts Medicare Assignment

1879 SAVAGE RD, CHARLESTON, SC 29407(843) 763-9472(843) 763-7411 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 30, 2026, May 26, 2021, Jan 27, 2021 (3 updates tracked since 2021).

On this page

About Heather Elizabeth Gordon Wallace Fnp NPPES

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

HEATHER ELIZABETH GORDON WALLACE FNP (NPI 1962993634) is an individual family provider in Charleston, South Carolina, licensed in South Carolina (21745) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with Bon Secours-st Francis Xavier Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1962993634

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameHEATHER ELIZABETH GORDON WALLACECredential: FNP

Location Address1879 SAVAGE RDCharleston, SC 29407-4726

Mailing AddressPo Box 751649Charlotte, NC 28275-1649 · (888) 472-0043 · Fax (843) 724-2440

Phone(843) 763-9472

Fax(843) 763-7411

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 29, 2018

Last NPPES UpdateMarch 30, 20263 updates tracked since enumeration

NPPES CertifiedMarch 30, 2026

✔ NPI 1962993634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in SC · 21745

1879 SAVAGE RD, Charleston, SC 29407

Open in Google Maps ↗

Other Identifiers 1

MedicaidNP5266SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.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

Heather Elizabeth Gordon Wallace Fnp 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 ID2961750195

PECOS Enrollment IDI20180806000123

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 3

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.

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.

123 services81 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

45 services44 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

38 services38 patients

Hospital Affiliations CMS Care Compare 3

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

Bon Secours-St Francis Xavier Hospital

Acute Care Hospitals · Charleston, SC

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420065

Location2095 Henry Tecklenburg DriveCharleston, SC 29414 · Charleston County

Emergency services Birthing friendly

Roper Hospital

Acute Care Hospitals · Charleston, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420087

Location316 Calhoun StCharleston, SC 29401 · Charleston County

Emergency services

Roper St Francis Hospital-Berkeley Inc

Acute Care Hospitals · Summerville, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420110

Location300 Callen BlvdSummerville, SC 29486 · Dorchester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29407 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

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$169.80 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 8

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

ROPER SAINT FRANCIS PHYSICIANS NETWORK

Obstetrics & Gynecology (Gynecologic Oncology)