Kimberly S Wallace MD LLC
NPI 1790537132 · Family Medicine Physician · Gambrills, MD
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kimberly S Wallace MD LLC is a Family Medicine Physician organization in Gambrills, MD (NPI 1790537132).
Provider details
- NPI number
- 1790537132
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lisa Coyer, Office Manager(410) 693-9648
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
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
- 2024-04-01
- Last updated
- 2024-04-01
- Certified
- 2024-04-01
Frequently asked questions
- What is Kimberly S Wallace MD LLC's NPI number?
- Kimberly S Wallace MD LLC's National Provider Identifier (NPI) is 1790537132, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kimberly S Wallace MD LLC?
- Kimberly S Wallace MD LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Kimberly S Wallace MD LLC located?
- Kimberly S Wallace MD LLC's practice location on file with NPPES is 1438 Defense Hwy Ste 201, Gambrills, MD 21054-2021.
- What is Kimberly S Wallace MD LLC's phone number?
- The practice phone number listed in the NPPES registry for Kimberly S Wallace MD LLC is (410) 721-3200.
- Does Kimberly S Wallace MD LLC accept Medicare?
- Kimberly S Wallace MD LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kimberly S Wallace MD LLC?
- The authorized official listed on Kimberly S Wallace MD LLC's NPPES record is Lisa Coyer, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kimberly S Wallace MD LLC's NPI active?
- Yes — Kimberly S Wallace MD LLC's NPI (1790537132) is active in the NPPES registry as of the last update on 2024-04-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.