Jordan Wallace, PA-C
NPI 1063291789 · Medical Physician Assistant · Little Rock, AR
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jordan Wallace, PA-C is a Medical Physician Assistant provider in Little Rock, AR (NPI 1063291789).
Provider details
- NPI number
- 1063291789
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA-1208 (AR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 3 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Acyclovir | 19 | 12 |
| Sulfamethoxazole/Trimethoprimbrand: Sulfamethoxazole-Trimethoprim | 14 | 12 |
| Levetiracetam | 12 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (2)
- 3 Medical Park Dr Ste 202Benton, AR 72015-3700Phone: (501) 507-6035Fax: (501) 776-9677
- 1300 Centerview DrLittle Rock, AR 72211-4349Phone: (501) 507-6035Fax: (833) 985-3162
Registry dates
- Enumerated
- 2023-09-22
- Last updated
- 2025-09-15
- Certified
- 2025-09-15
Frequently asked questions
- What is Jordan Wallace's NPI number?
- Jordan Wallace's National Provider Identifier (NPI) is 1063291789, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jordan Wallace's specialty?
- Jordan Wallace is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jordan Wallace located?
- Jordan Wallace's practice location on file with NPPES is 5620 W Markham St, Little Rock, AR 72205-3327.
- What is Jordan Wallace's phone number?
- The practice phone number listed in the NPPES registry for Jordan Wallace is (501) 508-7163.
- Does Jordan Wallace accept Medicare?
- Jordan Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jordan Wallace's NPI active?
- Yes — Jordan Wallace's NPI (1063291789) is active in the NPPES registry as of the last update on 2025-09-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.