MR. WALLACE MAXWELL GREEN (PAC) – Neurology Physician, NPI 1306979059
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Neurology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. WALLACE MAXWELL GREEN (PAC)
1275 HIGHWAY 54 W
STE.105
FAYETTEVILLE, GA 302144549
Phone: (770) 719-2965
Fax: (770) 719-2963
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $4,906.
Total Amount is formed as General ($4,906) + Research ($0) + Ownership ($0) = $4,906.
Last reported payment date: 2023-06-07 • Largest payer in this snapshot: ABBVIE INC. ($4,884).
Total Amount
$4,906
General + Research + Ownership
Payments
9
Total payment records
General Amount
$4,906
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $4,884 |
| Collegium Pharmaceutical, Inc. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30214)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.