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DR. WALLACE W WEATHERLY M.D.
NPI 1972558542
Orthopaedic Surgery in Jackson, MS

Active since May 23, 2006PECOS EnrolledAccepts Medicare Assignment
1801 CRANE RIDGE DR, SUITE C, JACKSON, MS 39216(601) 981-5633(601) 981-1844 Get Directions Write a Review

NPPES record last updated: December 19, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Wallace W Weatherly M.d. NPPES

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

DR. WALLACE W WEATHERLY M.D. (NPI 1972558542) is an individual orthopaedic surgery provider in Jackson, Mississippi, licensed in Mississippi (11796) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Rolling Plains Memorial Hospital, and is a graduate of University Of Mississippi School Of Medicine (1987).

NPPES Registry Identity

NPI1972558542
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. WALLACE W WEATHERLYCredential: M.D.
Location Address1801 CRANE RIDGE DR, SUITE CJackson, MS 39216-4902
Mailing Address907 E Sunflower Rd, Ste 102Cleveland, MS 38732-2830 · (662) 843-8885 · Fax (662) 843-2280
Phone(601) 981-5633
Fax(601) 981-1844
Sole ProprietorNo
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 1987
Enumeration DateMay 23, 2006
Last NPPES UpdateDecember 19, 2017
✔ NPI 1972558542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MS · 11796
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1801 CRANE RIDGE DR, Jackson, MS 39216
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Wallace W Weatherly M.d. 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 ID2365486511
PECOS Enrollment IDI20200205002517
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 Reassignments

2

Medicare enrollment records show Wallace Weatherly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bolivar Physician Practices LLC
103 mi
Family Medicine
218 N PEARMAN AVE
Cleveland, MS 38732
  • Reassigned Medicare billing, Mississippi enrollment
  • 42 clinicians in this Medicare group
NPI 1376787556 (662) 298-1730
Discovery Medical Network Sweetwater LLC
599 mi
Orthopaedic Surgery
301 JENNY GEORGE LN, BUILDING B
Sweetwater, TX 79556
  • Reassigned Medicare billing, Texas enrollment
  • 11 clinicians in this Medicare group
NPI 1134485550 (325) 325-6814

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

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 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.
181 services88 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
46 services46 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
35 services26 patients

Hospital Affiliations CMS Care Compare 3

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

Rolling Plains Memorial Hospital

Acute Care Hospitals · Sweetwater, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450055
Location200 E ArizonaSweetwater, TX 79556 · Nolan County
Emergency services Birthing friendly

Mitchell County Hospital District

Critical Access Hospitals · Colorado City, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451342
Location997 West I-20Colorado City, TX 79512 · Mitchell County
Emergency services

Cogdell Memorial Hospital

Critical Access Hospitals · Snyder, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451384
Location1700 Cogdell BlvdSnyder, TX 79549 · Scurry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
21%332 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
25%543 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
15%68 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,589 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%374 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
1%284 patients1/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
78%727 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%1,079 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
66%1,309 patients3/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
27%284 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
23%1,091 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
1%1,075 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 569 patients
Patients tobacco: 3% · 71 patients
81%569 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,309 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
8%1,309 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
16%1,309 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

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

KRISTEN RUTH WILLIAMS LPC
Counselor (Professional)
1801 CRANE RIDGE DR, SUITE A
JACKSON, MS 39216
Hinds County (601) 573-8642
WEATHERLY SPORTS MEDICINE & FAMILY ORTHOPAEDICS, PA
Orthopaedic Surgery
1801 CRANE RIDGE DR, SUITE C
JACKSON, MS 39216
Hinds County (601) 981-5633
THRESHOLDS COUNSELING AND CONSULTING PLLC
Counselor (Professional)
1801 CRANE RIDGE DR, SUITE A
JACKSON, MS 39216
Hinds County (601) 573-8642

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 Weatherly's NPI number?

The NPI number for Wallace Weatherly is 1972558542. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Wallace Weatherly located?

Wallace Weatherly practices at 1801 Crane Ridge Dr Suite C, Jackson, MS 39216. The listed phone number is (601) 981-5633.

What is Wallace Weatherly's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Wallace Weatherly enrolled in Medicare?

Yes. Wallace Weatherly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Wallace Weatherly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wallace Weatherly reassigns Medicare benefits to 2 organizations: Bolivar Physician Practices LLC (Cleveland, MS) and Discovery Medical Network Sweetwater LLC (Sweetwater, TX). Each 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 Wallace Weatherly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Wallace Weatherly accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Cigna Healthcare list Wallace Weatherly 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.

Is Wallace Weatherly affiliated with any hospitals?

According to CMS data, Wallace Weatherly is affiliated with Rolling Plains Memorial Hospital, Mitchell County Hospital District and Cogdell Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Wallace Weatherly was last updated on December 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.