Connie Sue Wallace (NPI# 1619179132, PAC ID# 7618063686) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1619179132 |
| PAC ID by PECOS | 7618063686 |
| Professional Enrollment ID | I20071022000844 |
| Full Name | Connie Sue Wallace |
| Organization Legal Name | THE PRESBYTERIAN HOSPITAL |
| Address |
10030 Gilead Rd Huntersville NC 28078-7545 |
| Gender | F |
| Graduation Year | 1998 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1153231907 |
| Number of Group Practice Members | 242 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340053 | NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 125 Baldwin Ave, Suite 200, Charlotte, NC 28204-3370 | 7043845043 | NOVANT MEDICAL GROUP INC |
| 1718 E 4th St, Charlotte, NC 28204-3197 | THE PRESBYTERIAN HOSPITAL | |
| 1918 Randolph Rd, Suite 350, Charlotte, NC 28207-1111 | 7043841750 | THE PRESBYTERIAN HOSPITAL |
| 200 Hawthorne Ln, Charlotte, NC 28204-2515 | NOVANT MEDICAL GROUP INC | |
| 10030 Gilead Rd, Huntersville, NC 28078-7545 | THE PRESBYTERIAN HOSPITAL |
| Organization Legal Name | THE PRESBYTERIAN HOSPITAL |
| Physicians | 258 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heather Jean Mathew | Nurse Practitioner | The Presbyterian Hospital | 1401 Matthews Township Pkwy, Suite 110, Matthews, NC 28105-5403 |
| Jason G Shultz | Hematology/oncology | The Presbyterian Hospital | 14135 Balntyn Corp Pl, Suite 200, Charlotte, NC 28277-3383 |
| Nusrat A Chaudhary | Hematology/oncology | The Presbyterian Hospital | 1700 Matthews Township Pkwy, Matthews, NC 28105-4658 |
| Melissa Ann Benson | Nurse Practitioner | The Presbyterian Hospital | 1640 E Roosevelt Blvd, Monroe, NC 28112-4017 |
| Daniel G Sayers | Emergency Medicine | The Presbyterian Hospital | Advanced Wound Care and Hyperbaric Medicine, 300 Billingsley Road Suite 105, Charlotte, NC 28211-1075 |
| Heather Holden | Rheumatology | The Presbyterian Hospital | 6324 Fairview Rd, Suite 310, Charlotte, NC 28210-4172 |
| Asaad E Ahmed | Hospitalist | The Presbyterian Hospital | 3330 Siskey Pkwy, Matthews, NC 28105-3222 |
| Aileen Deng | Internal Medicine | The Presbyterian Hospital | 1918 Randolph Rd, Suite 350, Charlotte, NC 28207-1111 |
| Tracy A Ellingson | Certified Registered Nurse Anesthetist (crna) | The Presbyterian Hospital | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Barbara White Williams | Certified Registered Nurse Anesthetist (crna) | The Presbyterian Hospital | 10030 Gilead Rd, Suite 201, Huntersville, NC 28078-7545 |
| Street Address |
10030 GILEAD RD |
| City | HUNTERSVILLE |
| State | NC |
| Zip | 28078-7545 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J Mcnelis | Anesthesiology | Providence Anesthesiology Associates Pa | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Lauren A Leggett | Nurse Practitioner | Novant Medical Group Inc | 10030 Gilead Rd, Suite 300, Huntersville, NC 28078-7545 |
| Tracy A Ellingson | Certified Registered Nurse Anesthetist (crna) | The Presbyterian Hospital | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Alfred L Rhyne | Orthopedic Surgery | Orthocarolina, Pa | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Barbara White Williams | Certified Registered Nurse Anesthetist (crna) | The Presbyterian Hospital | 10030 Gilead Rd, Suite 201, Huntersville, NC 28078-7545 |
| Thomas D Haser | Physician Assistant | Orthocarolina, Pa | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Derek A Melby | Internal Medicine | Novant Medical Group Inc | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Ashley E Lowe | Nurse Practitioner | Novant Medical Group Inc | 10030 Gilead Rd, Suite 345, Huntersville, NC 28078-7545 |
| Bradley L Anglemyer | Emergency Medicine | Mid Atlantic Emergency Medical Associates Pllc | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Tyler M Anderson | Physician Assistant | Orthocarolina, Pa | 10030 Gilead Rd, Huntersville, NC 28078-7545 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacy C Le | Internal Medicine | Progressive Medical Associates Pllc | 13220 Rosedale Hill Ave, Huntersville, NC 28078-0361 |
| Stacy K Mullet | Nurse Practitioner | Progressive Medical Associates Pllc | 13220 Rosedale Hill Ave, Huntersville, NC 28078-0361 |
| Mary C Head | Nurse Practitioner | Progressive Medical Associates Pllc | 13220 Rosedale Hill Ave, Huntersville, NC 28078-0361 |
| Yvonne Verla Tah | Nurse Practitioner | Pacs, PC | 8712 Lindholm Dr, Suite 302, Huntersville, NC 28078-1872 |
| Kimberly Mae Clements | Nurse Practitioner | Pacs, PC | 8712 Lindholm Dr, Suite 302, Huntersville, NC 28078-1872 |
| Nancy E Frye | Nurse Practitioner | Pacs, PC | 8712 Lindholm Dr, Suite 302, Huntersville, NC 28078-1872 |
| Amber Childers Giordano | Nurse Practitioner | Pacs, PC | 8712 Lindholm Dr, Suite 302, Huntersville, NC 28078-1872 |
| Leanna J Worsham | Nurse Practitioner | Pacs, PC | 8712 Lindholm Dr, Suite 302, Huntersville, NC 28078-1872 |
| Christine E Lemley | Optometry | 6634 April Mist Trl, Huntersville, NC 28078-2322 | |
| Amy N Scala | Physical Therapy | Holston Medical Group PC | 10210 Hickorywood Hill Ave, Suite 120, Huntersville, NC 28078-3345 |
| Find all physicians in zip 28078 | |||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | HUNTERSVILLE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Connie Sue 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.