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

Dr. Richard Peterkin Wallace, MD

Individual provider Family Medicine Physician · NPI 1275586448

Dr. Richard Peterkin Wallace, MD is a Family Practice in Clearwater, Florida. Graduated from Meharry Medical College School of Medicine in 2000, 26 years ago. Practices with Bayside Urgent Care Center Inc, a 4-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
26
Trained at
Meharry Medical College School of Medicine
Licensed in
FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1001 S Fort Harrison Ave Ste 101
Clearwater, FL 33756-3941
Phone: (727) 441-5044
Fax: (727) 441-5008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME85690 (FL)
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X · Licence ME85690 (FL)

Record details

NPI number1275586448
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 18, 2006
Last updated in NPPESSeptember 27, 2016

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesSPORTS MEDICINE
Medical schoolMEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Bayside Urgent Care Center Inc. — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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