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Active NPI 1487909511 Individual Practitioner Male Practitioner

John David Wallace , PA-C

Physician Assistant • East Jordan, MI

Professional Overview & Biography Verified Profile Summary

John Wallace, PA-C is a registered healthcare professional specializing in Physician Assistant in East Jordan, MI. Practice services are available at 601 BRIDGE ST under active NPI credentials.

Frequently performed procedures and clinical services include routine ekg using at least 12 leads including interpretation and report. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

601 Bridge St

East Jordan, MI 497279383

Telephone 2315362206
Fax 2315367150
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in East Jordan, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
1 Specialists

Practicing in East Jordan, MI (7057 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
70.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
93000 Routine ekg using at least 12 leads including interpretation and report
12 12 $48.00 $13.98

Medical Specialties & State Licenses

CMS Verified: 2022-09-20
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601006422

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Practice Locations

6135 Cressy St

Indian River, MI 497495151

Phone: 2312388908

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Maegan Chamberlain , LLMSW

Social Worker - Clinical

NPI 1033099056

Limited Licensed Master Social Worker

Joelle Woodruff

Nurse Practitioner - Family

NPI 1033566591
Jennifer Sampson , MSN, RN, FNP-BC

Nurse Practitioner - Family

NPI 1124530449

Master of Science in Nursing, Registered Nurse, Family Nurse Practitioner (Board Certified)

NPI 1124684527

Limited Licensed Master Social Worker

Molly Zubal

Nurse Practitioner

NPI 1164017125
NPI 1285625301

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location September 20, 2022

Registered at 601 BRIDGE ST, EAST JORDAN, MI 497279383 (Tel: 2315362206)

📍
Updated Business Mailing Address September 20, 2022

Registered at 601 BRIDGE ST, EAST JORDAN, MI 497279383 (Tel: 2315362206)

📍
Updated Practice Location February 26, 2019

Registered at 6135 CRESSY ST, INDIAN RIVER, MI 497495151 (Tel: 2312388908)

📍
Updated Business Mailing Address February 26, 2019

Registered at 6135 CRESSY ST, INDIAN RIVER, MI 497495151 (Tel: 2312388908)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 26, 2019

Physician Assistant (License #5601006422 in MI)

NPI Profile Active September 01, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 01, 2015

Registered at 1890 S US HIGHWAY 131, SUITE 4, PETOSKEY, MI 497708344 (Tel: 2314872000)

📍
Updated Business Mailing Address September 01, 2015

Registered at 1890 S US HIGHWAY 131, SUITE 4, PETOSKEY, MI 497708344 (Tel: 2314872000)

👤
Provider Name / Credentials Updated September 01, 2015

Recorded as JOHN WALLACE, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 01, 2015

Physician Assistant

🟢
Initial NPI Registration & Enumeration July 15, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487909511
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2012
Last Update: September 20, 2022
Sole Proprietor: No

Mailing Address

601 Bridge St

East Jordan, MI 497279383

Phone: 2315362206

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.