Kelley Annette Wallace, DO is a medicare enrolled "Hospitalist" physician in Kernersville, North Carolina. Her current practice location is
1750 Kernersville Medical Pkwy, Kernersville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 564-4866.
Kelley Annette Wallace is licensed to practice in North Carolina (license number 2012-00585) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1174753727.
Physician's Profile
Full Name | Kelley Annette Wallace |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 1750 Kernersville Medical Pkwy, Kernersville, North Carolina |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kelley Annette Wallace attended and graduated from in
NPI Data:
- NPI Number: 1174753727
- Provider Enumeration Date: 07/16/2009
- Last Update Date: 05/23/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Kelley Annette Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174753727 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | DO.1175 (Alabama) | Secondary |
208M00000X | Hospitalist | 2012-00585 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelley Annette Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelley Annette Wallace, DO Po Box 60447, Charlotte, NC 28260-0447 Ph: (336) 564-4866 | Kelley Annette Wallace, DO 1750 Kernersville Medical Pkwy, Kernersville, NC 27284-7146 Ph: (336) 564-4866 |
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