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Active NPI 1013697267 Individual Practitioner Male Practitioner

Jesse L Wallace , AG-ACNP

Nurse Practitioner - Acute Care • Charlottesville, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jesse Wallace, AG-ACNP is a certified Nurse Practitioner - Acute Care practicing in Charlottesville, VA. With approximately 3 years of clinical experience since completing medical education in 2023, Jesse Wallace delivers high-quality medical care to the local community at 500 MARTHA JEFFERSON DR STE 505.

Jesse Wallace is affiliated with University Of Virginia Physicians Group and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

500 Martha Jefferson Dr Ste 505

Charlottesville, VA 229114668

Telephone 4346545260
Fax 4346545261

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Acute Care in Charlottesville, VA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -5.7 yrs vs City Avg
City Avg: 8.7 Yrs
State Avg: 8.9 Yrs
Regional Practice Density
209 Specialists

Practicing in Charlottesville, VA (940 Statewide)

Telehealth Adoption Rate
15.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (3 Years) 3 Yrs
Charlottesville Specialty Average (8.7 Years) 8.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-05-11
Nurse Practitioner - Acute Care Primary Specialty

NUCC Taxonomy Code: 363LA2100X

State License VA 0024187479

Definition to come...

Anesthesiology - Critical Care Medicine

NUCC Taxonomy Code: 207LC0200X

State License VA 0024187479

An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID None
NONE

Hospital & Practice Group Affiliations

University Of Virginia Physicians Group

1215 Lee St, Charlottesville, VA 229082325

Phone: 4349248129

Secondary Practice Locations

1215 Lee St

Charlottesville, VA 229080816

Phone: 4349243627

Practice Associates & Co-Workers

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

31 Associated Practitioners
Dr. Jeffrey Mai , MD, PhD

Neurological Surgery

NPI 1013025857

Doctor of Medicine (M.D.), Doctor of Philosophy (Ph.D.)

NPI 1033575386
Dr. James Freeman , MD

Internal Medicine

NPI 1053529669

Doctor of Medicine (M.D.)

Dr. Christopher Willms , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1093786329

Doctor of Medicine (M.D.)

Dr. Samuel Oliver , MD

Internal Medicine - Critical Care Medicine

NPI 1134573215

Doctor of Medicine (M.D.)

Dr. John Watson , MD

Internal Medicine - Pulmonary Disease

NPI 1144617424

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

12 Historical Events
📍
Updated Practice Location May 11, 2026

Registered at 500 MARTHA JEFFERSON DR STE 505, CHARLOTTESVILLE, VA 229114668 (Tel: 4346545260)

📍
Updated Business Mailing Address May 11, 2026

Registered at 500 MARTHA JEFFERSON DR STE 505, CHARLOTTESVILLE, VA 229114668 (Tel: 4346545260)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2026

Nurse Practitioner (License #0024187479 in VA)

📍
Updated Business Mailing Address December 06, 2024

Registered at PO BOX 749112, ATLANTA, GA 303749112

👤
Provider Name / Credentials Updated December 06, 2024

Recorded as JESSE WALLACE, AG-ACNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 06, 2024

Anesthesiology (License #0024187479 in VA)

NPI Profile Active July 24, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location July 24, 2023

Registered at 1215 LEE ST, CHARLOTTESVILLE, VA 229080816 (Tel: 4349243627)

📍
Updated Business Mailing Address July 24, 2023

Registered at 1115 GERMANTOWN AVE UNIT 2A, PHILADELPHIA, PA 191231869 (Tel: 2528860066)

👤
Provider Name / Credentials Updated July 24, 2023

Recorded as JESSE WALLACE, RN, APRN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2023

Nurse Practitioner (License #0024187479 in VA)

🟢
Initial NPI Registration & Enumeration July 24, 2023

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: 1013697267
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2023
Last Update: May 11, 2026
Sole Proprietor: No

Mailing Address

500 Martha Jefferson Dr Ste 505

Charlottesville, VA 229114668

Phone: 4346545260

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.