Richard Jeremy Wallace (NPI# 1841583788, PAC ID# 2365706223) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1841583788 |
| PAC ID by PECOS | 2365706223 |
| Professional Enrollment ID | I20190409003048 |
| Full Name | Richard Jeremy Wallace |
| Organization Legal Name | LOW COUNTRY HEALTH CARE SYSTEM |
| Address |
86 Wren St Barnwell SC 29812-1529 |
| Phone Number | 8032595762 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4284530940 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420082 | AIKEN REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 86 Wren St, Barnwell, SC 29812-1529 | 8032595762 | LOW COUNTRY HEALTH CARE SYSTEM |
| Organization Legal Name | LOW COUNTRY HEALTH CARE SYSTEM |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Young | Clinical Social Worker | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Richard E Boyles Jr. | Family Medicine | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Heinz Peter Schafer | Preventative Medicine | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Bobbie Ayers Jr. | Family Medicine | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Vickie B Glover | Physician Assistant | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Janet Mckissick | Family Medicine | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Naomi R Richardson | Certified Nurse Midwife (cnm) | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Lucille Miley | Nurse Practitioner | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Rebecca Lynn Wilkes | Nurse Practitioner | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Ashley A Boulware | Nurse Practitioner | Low Country Health Care System | 526 N St, Bamberg, SC 29003-1319 |
| Street Address |
86 WREN ST |
| City | BARNWELL |
| State | SC |
| Zip | 29812-1529 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Young | Clinical Social Worker | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Weems Pennington | Cardiovascular Disease (cardiology) | Heart and Vascular Associates of Augusta P.C. | 86 Wren St, Barnwell, SC 29812-1529 |
| Vickie B Glover | Physician Assistant | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Naomi R Richardson | Certified Nurse Midwife (cnm) | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Alexander M Hovey | Physician Assistant | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Kim C Terry | Physician Assistant | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Heather R Nolan | Nurse Practitioner | Low Country Health Care System | 86 Wren St, Barnwell, SC 29812-1529 |
| Marsha W Sandifer | Nurse Practitioner | Low Country Health Care System, Inc. | 86 Wren St, Barnwell, SC 29812-1529 |
| Bryan Burnett | Pediatric Medicine | Low Country Health Care System, Inc. | 86 Wren St, Barnwell, SC 29812-1529 |
| James Robert Mynatt | Nurse Practitioner | Low Country Health Care System, Inc. | 86 Wren St, Barnwell, SC 29812-1529 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martin L Shealy | Chiropractic | 76 Irving St, Barnwell, SC 29812-1500 | |
| Sharon Wise | Nurse Practitioner | 154 Wren St, Barnwell, SC 29812-1527 | |
| Abraham Moskow | Pediatric Medicine | Low Country Health Care System, Inc. | 86 Wren St, Barnwell, SC 29812-1529 |
| Kendall Hartzog | Chiropractic | 7245 Barnwell Rd, Barnwell, SC 29812-5532 | |
| Candace C Kirby | Nurse Practitioner | Low Country Health Care System, Inc. | 10706 Marlboro Ave, Barnwell, SC 29812-6376 |
| Joel C Greene Jr. | Chiropractic | 11022 Ellenton St, Barnwell, SC 29812-7306 |
| City | BARNWELL |
| Zip Code | 29812 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BARNWELL + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Richard Jeremy Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.