WILLIAM JACOB WALLACE PA
NPI 1992183412
Physician Assistant - Surgical in Cookeville, TN

Q: What is William Wallace's NPI number?

The NPI number for William Wallace is 1992183412. It was assigned to this individual provider in the NPPES registry on May 16, 2015.

Q: What is William Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for William Wallace was last updated on August 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 16, 2015PECOS EnrolledAccepts Medicare Assignment

74.96/100

CMS Quality Rating

105 S WILLOW AVE, COOKEVILLE, TN 38501(931) 372-7716(931) 372-0087 Get Directions Write a Review

NPPES record last updated: August 27, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About William Jacob Wallace Pa NPPES

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

WILLIAM JACOB WALLACE PA (NPI 1992183412) is an individual surgical provider in Cookeville, Tennessee, licensed in Tennessee (PA2743) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Cookeville Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1992183412

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameWILLIAM JACOB WALLACECredential: PA

Location Address105 S WILLOW AVECookeville, TN 38501-4667

Mailing Address203 N Cedar AveCookeville, TN 38501-2498 · (931) 528-1992 · Fax (931) 526-4381

Phone(931) 372-7716

Fax(931) 372-0087

Sole ProprietorYes

Medical School CMSOtherGraduated 2014

Enumeration DateMay 16, 2015

Last NPPES UpdateAugust 27, 2020

NPPES CertifiedAugust 27, 2020

✔ NPI 1992183412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in TN · PA2743

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 2743 (TN)

105 S WILLOW AVE, Cookeville, TN 38501

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Secondary Practice Locations 2

Location 1150 Sam Walton Dr, #600Sparta, TN 38583-8815 · Phone (931) 739-4000

Location 2203 N Cedar AveCookeville, TN 38501 · Phone (931) 528-1992 ext. 114 · Fax (931) 526-4381

Other Identifiers 1

MedicaidQ015216TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health 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 and accepts Medicare assignment

William Jacob Wallace Pa 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 ID4284934035

PECOS Enrollment IDI20151130001155

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 12

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.

128 services102 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.

89 services64 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.

76 services76 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

63 services46 patients

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.

63 services62 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

56 services42 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

34 services28 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

33 services28 patients

X-ray of wrist, 2 views 73100

An X-ray of the wrist, 2 views, is a diagnostic procedure where two different images of your wrist are taken using a small amount of radiation. This helps identify any abnormalities or injuries such as fractures or arthritis. It's a quick, non-invasive process.

29 services21 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

29 services29 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

22 services19 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

19 services17 patients

Hospital Affiliations CMS Care Compare

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

Cookeville Regional Medical Center

Acute Care Hospitals · Cookeville, TN

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number440059

Location1 Medical Center BoulevardCookeville, TN 38501 · Putnam County

Emergency services Birthing friendly

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.

74.96/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

64.72

Promoting Interoperability

Improvement Activities

Cost

60.14

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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.

JOSEPH C ARCHER ANP C

Nurse Practitioner

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 526-9518

GREGORY J ROBERTS MD

Orthopaedic Surgery

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 526-9518

MR. RICHARD TODD BURKS PT

Physical Therapist

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 253-1973

BRIAN HUFF DO

Orthopaedic Surgery

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 526-9518

GEOFFREY D RODGERS OPAC

Physician Assistant

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (913) 526-9518

CUMBERLAND NEUROLOGICAL AND SPINAL SURGERY

Neurological Surgery

105 S WILLOW AVE, SUITE 200
COOKEVILLE, TN 38501

Putnam County (931) 372-7716

JAMES D MCKINNEY MD

Orthopaedic Surgery

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 526-9518

CAMPBELL CLINIC PC

Durable Medical Equipment & Medical Supplies

105 S WILLOW AVE
COOKEVILLE, TN 38501

Putnam County (931) 526-9518

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 William Wallace's NPI number?

The NPI number for William Wallace is 1992183412. It was assigned to this individual provider in the NPPES registry on May 16, 2015.

Where is William Wallace located?

William Wallace practices at 105 S Willow Ave, Cookeville, TN 38501. The listed phone number is (931) 372-7716.

What is William Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is William Wallace enrolled in Medicare?

Yes. William Wallace 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.

What insurance does William Wallace accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list William 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.

Is William Wallace affiliated with any hospitals?

According to CMS data, William Wallace is affiliated with Cookeville Regional Medical Center.

When was this NPI record last updated?

The NPPES record for William Wallace was last updated on August 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.