KIMBERLY SHANNON WALLACE MD NPI 1770627705

NPI Details

Kimberly Shannon Wallace, MD is a family medicine in Gambrills, MD with 22 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Kimberly Shannon Wallace, MD NPI is 1770627705. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Graduation Year:2004

The provider's business location address is:

1438 DEFENSE HWY SUITE 201
GAMBRILLS, MD
ZIP 21054
Phone: (410) 721-3200
Fax: (410) 721-2680

The NPI 1770627705 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Injection, denosumab, 1 mg (HCPCS:J0897)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent derived from recombinant dna (HCPCS:90682)
• Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
• Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
• Injection of drug or substance under skin or into muscle (HCPCS:96372)
• Manual urinalysis test with examination using microscope, non-automated (HCPCS:81000)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
• Removal of impacted ear wax (HCPCS:69210)

The enumeration date for this NPI number is 2/15/2007 and was last updated on 3/18/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: