Shana Wallace, MD
Shana Wallace, MD is a Neurology with Special Qualifications in Child Neurology Physician in Charlotte, NC, registered under NPI 1013040666. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1900 RANDOLPH RD SUITE 1010, Charlotte, NC 28207. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 2004-01063 | NC | Pediatric Neurodevelopmental Disabilities… |
| 200401063 | NC | Neurology with Special Qualifications in… primary |
This provider holds licence 2004-01063 issued in NC. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Neurology
- PAC ID
- 4880832401
- Enrollment ID
- I20180927000218
Medicare enrolment is recorded as approved under the provider type Practitioner - Neurology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Neurology with Special Qualifications in Child Neurology covers
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. NUCC Health Care Provider Taxonomy, code 2084N0402X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2080P0008X | Pediatric Neurodevelopmental Disabilities Physician Neurodevelopmental Disabilities | 2004-01063 | NC | |
| 2084N0402X | Neurology with Special Qualifications in Child Neurology Physician Neurology with Special Qualifications in Child Neurology | 200401063 | NC | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1013040666 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 13, 2007 |
| Last updated | Oct 25, 2020 |
| Status | Active |
| Sole proprietor | No |
| Gender | Female |
| Credential | MD |
| Practice address |
1900 RANDOLPH RD SUITE 1010 Charlotte, NC 28207 (704) 384-1390 Fax (704) 384-1063 |
| Mailing address |
PO BOX 60447 Charlotte, NC 28260 |
| Other names |
Shana Green Former Legal Business Name |
| Other identifiers |
200401063
· Other (NC) 5907566 · Medicaid (NC) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 1 | 3 | 0 | 4 | 0 | 6 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 2 | 3 | 0 | 4 | 0 | 6 | 3 |
Sum = 44 · next multiple of 10 = 50 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.