NPI age
20 years
Enumerated 2006-05-17
● Active
Type 1 · Individual
Lucy-Bertha Wallang, PA-C
Wallang is 1 of 36 physician assistant providers in Snellville and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 7 subspecialties
Licensed in
GA, CA, NY, FL, DC, IA, WI
7 states
Status
Active
No deactivations on record
Last NPPES update
2024-06-06
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
20 years
↑ 12 yr above median (8 yr)
State licenses
7 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 24% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-05Enumerated in NPPES
2006
2026
Where they practice
Practice location
2675 Main St W
Snellville, GA 300783161
Mailing address
2545 Alexa Chase Cv
Dacula, GA 300197578
Additional practice locations
6 secondary locations on file with NPPES.
Location 2
333 1st St Ste A
San Francisco, CA 941052661
Location 3
400 N Tampa St Fl 15
Tampa, FL 336024730
Location 4
505 E Grand Ave Ste 200
Des Moines, IA 503091977
Location 5
156 William St Rm 303
New York, NY 100385307
Location 6
1331 H St Nw Ste 200
Washington, DC 200054706
Location 7
790 N Milwaukee St Ste 313
Milwaukee, WI 532024148
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
-
Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 723874491A | |
| 01 (GA) | 11143 | BLUE CROSS BLUE SHIELD |
| 05 (GA) | 723874491B | |
| 01 (GA) | 01076922 | AMERIGROUP |
| 01 (GA) | 333656 | WELLCARE |
| 05 (GA) | 723874491 |
Multi-state credentialing: Licensed in 7 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.