Alexis Nicole Wallace, MD - Medicare Internal Medicine in 1120 15th St, GA

Alexis Nicole Wallace, MD is a medicare enrolled "Internal Medicine" physician in 1120 15th St, Georgia. Her current practice location is Augusta University Medical Center, 1120 15th St, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 721-2273.

Alexis Nicole Wallace is licensed to practice in Georgia (license number 12864) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1245856822.

Contact Information

Alexis Nicole Wallace, MD
Augusta University Medical Center,
1120 15th St, GA 30912
(706) 721-2273
Not Available



Physician's Profile

Full NameAlexis Nicole Wallace
GenderFemale
SpecialityInternal Medicine
LocationAugusta University Medical Center, 1120 15th St, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1245856822
  • Provider Enumeration Date: 06/19/2020
  • Last Update Date: 12/15/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 6002217619
  • Enrollment ID: I20210701003855

Medical Identifiers

Medical identifiers for Alexis Nicole Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245856822NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine LL84507 (South Carolina)Secondary
207R00000XInternal Medicine 12864 (Georgia)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. Alexis Nicole 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
Alexis Nicole Wallace, MD
Internal Medicine Residency 1120 15th St,
Augusta, GA 30912-0001

Ph: (706) 721-2273
Alexis Nicole Wallace, MD
Augusta University Medical Center,
1120 15th St, GA 30912

Ph: (706) 721-2273

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Internal Medicine Doctors in 1120 15th St, GA


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