Kelley Annette Wallace, DO - Medicare Hospitalist in Kernersville, NC

  1. Home
  2. Hospitalist
  3. NC
  4. Kernersville
Kelley Annette Wallace, DO is a medicare enrolled "Hospitalist" physician in Kernersville, North Carolina. She graduated from medical school in 2009 and has 15 years of diverse experience with area of expertise as Hospitalist. She is a member of the group practice Novant Medical Group Inc, Forsyth Memorial Hospital Inc and 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.

Contact Information

Kelley Annette Wallace, DO
1750 Kernersville Medical Pkwy,
Kernersville, NC 27284-7146
(336) 564-4866
(336) 277-6815

Map and Direction




Physician's Profile

Full NameKelley Annette Wallace
GenderFemale
SpecialityHospitalist
Experience15 Years
Location1750 Kernersville Medical Pkwy, Kernersville, North Carolina
Accepts Medicare AssignmentsYes. 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 graduated from medical school in 2009
  NPI Data:
  • NPI Number: 1174753727
  • Provider Enumeration Date: 07/16/2009
  • Last Update Date: 05/23/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2567633001
  • Enrollment ID: I20120829000092

Medical Identifiers

Medical identifiers for Kelley Annette Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174753727NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine DO.1175 (Alabama)Secondary
208M00000XHospitalist 2012-00585 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Novant Health Forsyth Medical CenterWinston-salem, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Novant Medical Group Inc11532348932023
Forsyth Memorial Hospital Inc9537071790516

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelley Annette Wallace allows following entities to bill medicare on her behalf.
Entity NameWake Forest Health Network Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477785756
PECOS PAC ID: 4183538895
Enrollment ID: O20031117000868
Entity NameNovant Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366409492
PECOS PAC ID: 1153234893
Enrollment ID: O20031121000692
Entity NameNovant Health Thomasville Medical Center Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033160205
PECOS PAC ID: 5890605224
Enrollment ID: O20031222000916
Entity NameThe Presbyterian Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053365817
PECOS PAC ID: 1153231907
Enrollment ID: O20040223001121
Entity NameForsyth Memorial Hospital Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104548874
PECOS PAC ID: 9537071790
Enrollment ID: O20040405001702

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 AddressPractice 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

Reviews and Comments


Hospitalist Doctors in Kernersville, NC


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.