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NPI · 1063291789 · NPPES-sourced

Mrs. Jordan Wallace PA-C

ActiveMedical Physician Assistant
NPI Number
1063291789
Type 1 · Individual
Taxonomy Code
363AM0700X
Contact
(501) 508-7163
License AR · PA-1208
Last Updated
Enumerated
Primary practice addressAR · 72205-3327
5620 W Markham StLittle Rock, AR 72205-3327
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About this NPIWhat this record shows.

NPI 1063291789 is registered to Mrs. Jordan Wallace PA-C, a Medical Physician Assistant practising at 5620 W Markham St in Little Rock, Arkansas. Medical Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Mrs. Jordan Wallace PA-C has been enumerated in the National Provider Identifier (NPI) registry since 2023.

Provider type
Individual (Type 1)
Status
Active
Enumerated
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Mrs. Jordan Wallace PA-C accepts. To confirm in-network status with your specific health plan, contact Mrs. Jordan Wallace PA-C directly at (501) 508-7163.

Frequently asked

Yes. NPI 1063291789 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Medical Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (501) 508-7163.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Mrs. Jordan Wallace PA-C is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363AM0700X
Last updated
Enumerated
StatusActive
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