Kellie L Wallace-wilding, MD in Jackson, TN

Kellie L Wallace-wilding, MD is a medicare enrolled "Family Medicine" physician in Jackson, Tennessee. She graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Jackson Clinic Pa and her current practice location is 2863 Highway 45 Byp, Jackson, Tennessee. You can reach out to her office (for appointments etc.) via phone at (731) 664-1375.

Kellie L Wallace-wilding is licensed to practice in Tennessee (license number 41583) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063518629.

Contact Information

	Kellie L Wallace-wilding, MD
	2863 Highway 45 Byp, Jackson, TN 38305-3618
	(731) 664-1375
	(731) 664-1378

Map and Direction

Physician's Profile

Full Name	Kellie L Wallace-wilding
Gender	Female
Speciality	Family Practice
Experience	19 Years
Location	2863 Highway 45 Byp, Jackson, Tennessee
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kellie L Wallace-wilding graduated from medical school in 2005

NPI Data:

NPI Number: 1063518629
Provider Enumeration Date: 09/14/2006
Last Update Date: 11/29/2012

Medicare PECOS Information:

PECOS PAC ID: 3971504457
Enrollment ID: I20070125000551

Medical Identifiers

Medical identifiers for Kellie L Wallace-wilding such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063518629	NPI	-	NPPES
3827516	Medicaid	TN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	41583 (Tennessee)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Tennessee Quality Care - Home Health	Parsons, TN	Home health agency
Medical Center Home Health	Jackson, TN	Home health agency
Volunteer Home Care	Humboldt, TN	Home health agency
Tennessee Quality Hospice	Jackson, TN	Hospice
Jackson-madison County General Hospital	Jackson, TN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Jackson Clinic Pa	2668376872	176

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kellie L Wallace-wilding allows following entities to bill medicare on her behalf.

Entity Name	Jackson Clinic Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285629386 PECOS PAC ID: 2668376872 Enrollment ID: O20040318000962

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. Kellie L Wallace-wilding 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 Address	Practice Location Address
Kellie L Wallace-wilding, MD Po Box 400, Jackson, TN 38302-0400 Ph: (731) 423-8697	Kellie L Wallace-wilding, MD 2863 Highway 45 Byp, Jackson, TN 38305-3618 Ph: (731) 664-1375

Reviews and Comments

Family Medicine Doctors in Jackson, TN

Parker Panovec, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2859 Highway 45 Byp, Jackson, TN 38305 Phone: 731-660-8360 Fax: 731-664-7928
Michael James Martin, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 294 Summar Dr, Jackson, TN 38301 Phone: 731-423-1932 Fax: 731-410-0367
Melissa A Robbins, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 294 Summar Drive, Jackson, TN 38301 Phone: 731-423-1932 Fax: 731-423-4919
Dr. Ezekiel Oladejo Adetunji, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 150 Murray Guard Dr, Jackson, TN 38305 Phone: 731-300-3168 Fax: 731-300-3169
Kenneth R. Warren, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 31 Physicians Dr, Suite 1, Jackson, TN 38305 Phone: 731-664-0103 Fax: 731-664-5666
Anna Elizabeth Glass Burgess, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2863 Highway 45 Byp, Jackson, TN 38305 Phone: 731-664-1375 Fax: 731-664-1378
Christopher Reyes Caangay, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 294 Summar Dr, Jackson, TN 38301 Phone: 731-541-3755

Kellie L Wallace-wilding, MD - Medicare Family Practice in Jackson, TN