DR. WALLACE W WEATHERLY (M.D.) – Orthopaedic Surgery Physician, NPI 1972558542
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
284 ORTHOPEDIC SURGERY in MS
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Provider Addresses for DR. WALLACE W WEATHERLY (M.D.)
907, East Sunflower Road, Cleveland, Bolivar County, Mississippi, 38732, United States
STE 102
CLEVELAND, MS 387322830
Phone: (662) 843-8885
Fax: (662) 843-2280
Type: Mailing
1801, Crane Ridge Drive, Jackson, Hinds County, Mississippi, 39216, United States
SUITE C
JACKSON, MS 392164902
Phone: (601) 981-5633
Fax: (601) 981-1844
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $51.
Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.
Last reported payment date: 2023-03-08 • Largest payer in this snapshot: Pylant Medical ($51).
Total Amount
$51
General + Research + Ownership
Payments
1
Total payment records
General Amount
$51
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pylant Medical | $51 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-02-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050620000139 | I | Orthopedic Surgery | MS | TBD |
| I20200205002517 | I | Orthopedic Surgery | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 225 | 114 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 58 | 58 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 37 | 31 | $0 |
Insurance plans in this area (ZIP 38732)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | MS | 20610 | Aspiration and/or injection of large joint or joint capsule | 71 | 67 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| General Surgery | KS | |
| Pediatric Medicine | TX | |
| Family Practice, Obstetrics/Gynecology | TX |
Reviews
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