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

Mrs. Jordan Jehree Wallace, PA-C

Individual provider Medical Physician Assistant · NPI 1063291789

Mrs. Jordan Jehree Wallace, PA-C is a Physician Assistant in Little Rock, Arkansas. Qualified in 2023, 3 years ago. Practices with American Oncology Partners PA, a 383-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
3
Licensed in
AR
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

5620 W Markham St
Little Rock, AR 72205-3327
Phone: (501) 508-7163
Fax: (501) 203-9850
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3 Medical Park Dr Ste 202, Benton, AR 72015-3700 — (501) 507-6035
  • 1300 Centerview Dr, Little Rock, AR 72211-4349 — (501) 507-6035

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-1208 (AR)
Physician Assistant Taxonomy 363A00000X · Licence PA-1208 (AR)

Record details

NPI number1063291789
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 22, 2023
Last updated in NPPESSeptember 15, 2025
Certification dateSeptember 15, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice American Oncology Partners Pa — 383 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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