Ellis Wallace, PA-C
NPI 1538241815 · Medical Physician Assistant · Fort Stewart, GA
Ellis Wallace, PA-C is a Medical Physician Assistant provider in Fort Stewart, GA (NPI 1538241815).
Provider details
- NPI number
- 1538241815
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 002533 (GA)
Specialties & taxonomies
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
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-10-19
- Last updated
- 2011-03-10
Frequently asked questions
- What is Ellis Wallace's NPI number?
- Ellis Wallace's National Provider Identifier (NPI) is 1538241815, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ellis Wallace's specialty?
- Ellis Wallace is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ellis Wallace located?
- Ellis Wallace's practice location on file with NPPES is 1061 Harmon Ave, Fort Stewart, GA 31314-5641.
- What is Ellis Wallace's phone number?
- The practice phone number listed in the NPPES registry for Ellis Wallace is (912) 435-6633.
- Is Ellis Wallace's NPI active?
- Yes — Ellis Wallace's NPI (1538241815) is active in the NPPES registry as of the last update on 2011-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.