Jacob Wallis
NPI 1568118172 · Physician Assistant · Fayetteville, GA
Jacob Wallis is a Physician Assistant provider in Fayetteville, GA (NPI 1568118172).
Provider details
- NPI number
- 1568118172
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 4879 (TN)
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 tenure33% of score
4 yrs in NPPES registry
- Profile completeness33% of score
100% of core fields populated
- Practice footprint20% of score
3 documented practice locations
- Open Payments transparency13% of score
Has Open Payments disclosures (2024)
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.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$19 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (2)
- 60 John C Breckenridge CvAdamsville, TN 38310-5089Phone: (731) 646-0182
- 6515 Poplar Ave Ste 106Memphis, TN 38119-4878Phone: (901) 426-1090Fax: (901) 426-1091
Registry dates
- Enumerated
- 2022-02-23
- Last updated
- 2024-11-21
- Certified
- 2024-11-21
Frequently asked questions
- What is Jacob Wallis's NPI number?
- Jacob Wallis's National Provider Identifier (NPI) is 1568118172, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Wallis's specialty?
- Jacob Wallis is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jacob Wallis located?
- Jacob Wallis's practice location on file with NPPES is 104 N Park Dr, Fayetteville, GA 30214-1645.
- What is Jacob Wallis's phone number?
- The practice phone number listed in the NPPES registry for Jacob Wallis is (470) 944-5290.
- Is Jacob Wallis's NPI active?
- Yes — Jacob Wallis's NPI (1568118172) is active in the NPPES registry as of the last update on 2024-11-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.