Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colby Rip Wallace, PA

Individual provider Physician Assistant · NPI 1396477840

Colby Rip Wallace, PA is a Physician Assistant in Henderson, North Carolina. Qualified in 2022, 4 years ago. Practices with Duke University Health System, Inc, a 1,082-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone: (919) 461-0017
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 781 Avent Ferry Rd Ste 102, Holly Springs, NC 27540-7776 — (919) 567-6120

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-12596 (NC)

Record details

NPI number1396477840
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 24, 2022
Last updated in NPPESSeptember 27, 2023
Certification dateSeptember 27, 2023
Mailing address1218 Maroon Dr, Durham, NC 27713-8233

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Duke University Health System, Inc — 1082 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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