Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Mr. Terrell Richard Wallace Jr., PA C

Medical Physician Assistant in Warner Robins, GA · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1356399828

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Registry record

Entity type Individual (Type 1)

Name Mr. Terrell Richard Wallace Jr.

Credential PA C

Sex Male

Practice address 136 South Houston Lake Road, Warner Robins, GA, 31088

Phone (478) 953-1020

Fax (478) 953-5406

Enumeration date May 5, 2006

Last updated in NPPES Sep 18, 2012

Taxonomy & licenses

363AM0700X Medical Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 002665 (GA) Primary

Other identifiers

Identifier	Type	State	Issuer
DC3326	Other	-	MCR RR
P00162033	Other	-	MCR RR

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Terrell Wallace?

The National Provider Identifier (NPI) for Terrell Wallace is 1356399828, a Type 1 (individual) record in the CMS NPPES registry.

Where does Terrell Wallace practice?

The practice location on file with NPPES is in Warner Robins, GA. Providers can have multiple locations; NPPES lists the primary practice address.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-09-18.