JOHN GRAY WALLACE M.D. NPI 1831486596

NPI Information

  • NPI: 1831486596
  • Provider Name: JOHN GRAY WALLACE, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 332 HIGHWAY 12 W
    KOSCIUSKO, MS
    ZIP 39090
  • Phone: (662) 289-1800

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NPI Details

John Gray Wallace, M.D. is a family medicine in Kosciusko, MS with 15 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. John Gray Wallace, M.D. NPI is 1831486596. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

332 HIGHWAY 12 W
KOSCIUSKO, MS
ZIP 39090-209
Phone: (662) 289-1800
Fax: (662) 289-2486

The NPI 1831486596 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)
  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
  • Blood test, basic group of blood chemicals (calcium, total) (HCPCS:80048)
  • Blood test, thyroid stimulating hormone (tsh) (HCPCS:84443)
  • Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Annual depression screening, 15 minutes (HCPCS:G0444)
  • Liver enzyme (sgot), level (HCPCS:84450)
  • Liver enzyme (sgpt), level (HCPCS:84460)
  • Hemoglobin a1c level (HCPCS:83036)
  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Manual urinalysis test with examination using microscope, automated (HCPCS:81001)
  • Creatinine level to test for kidney function or muscle injury (HCPCS:82570)
  • Cyanocobalamin (vitamin b-12) level (HCPCS:82607)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Injection, ceftriaxone sodium, per 250 mg (HCPCS:J0696)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Detection test by immunoassay technique for influenza virus (HCPCS:87400)
  • Vitamin d-3 level (HCPCS:82306)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)
  • Ct scan for measuring calcium and other minerals in bone (HCPCS:77078)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) (HCPCS:87880)
  • Natriuretic peptide (heart and blood vessel protein) level (HCPCS:83880)
  • Prostate cancer screening; prostate specific antigen test (psa) (HCPCS:G0103)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
  • Blood test, comprehensive group of blood chemicals (HCPCS:80053)
  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle (HCPCS:96401)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a (HCPCS:G0179)
  • Magnesium level (HCPCS:83735)
  • Blood potassium level (HCPCS:84132)
  • Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • Uric acid level, blood (HCPCS:84550)
  • Transitional care management services for problem of high complexity (HCPCS:99496)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Hospital discharge day management, more than 30 minutes (HCPCS:99239)
  • Removal of impacted ear wax (HCPCS:69210)
  • Thyroxine (thyroid chemical), free (HCPCS:84439)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Calcium level, total (HCPCS:82310)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Red blood cell sedimentation rate, to detect inflammation, non-automated (HCPCS:85651)
  • Routine electrocardiogram (ecg) using at least 12 leads with tracing (HCPCS:93005)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • Transitional care management services for problem of moderate complexity (HCPCS:99495)
  • Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and (HCPCS:G0180)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Skin test for tuberculosis (HCPCS:86580)
  • Mri scan of brain without contrast (HCPCS:70551)
  • Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)
  • Follow-up nursing facility visit per day, typically 35 minutes (HCPCS:99310)
  • Initial nursing facility visit per day, typically 35 minutes (HCPCS:99305)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ferritin (blood protein) level (HCPCS:82728)
  • Psa (prostate specific antigen) measurement, total (HCPCS:84153)
  • Mri scan of lower spinal canal without contrast (HCPCS:72148)
  • Mri scan of leg joint without contrast (HCPCS:73721)
  • Nursing facility discharge management, more than 30 minutes (HCPCS:99316)

The enumeration date for this NPI number is 7/1/2011 and was last updated on 9/22/2014.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine22522MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
107830815MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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