EXCLUDEDPROVIDER
Individual Revocation

Gerald Adrian Jr Wallace

Redmond, OR 97756

Public HHS-OIG LEIE exclusion record

Gerald Adrian Jr Wallace of Redmond, OR is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1265478416 with a primary specialty of Registered Nurse. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Gerald Adrian Jr Wallace is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of January 20, 2015.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Redmond, OR 97756
Exclusion date
January 20, 2015
Exclusion type
Revocation (1128b4)
NPI
1265478416

Record summary

Gerald Adrian Jr Wallace appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Redmond, Oregon. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is January 20, 2015, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateJanuary 20, 2015
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1265478416
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Redmond, OR 97756. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.

NPI Registry context

The LEIE record lists NPI 1265478416. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Registered Nurse (163W00000X). Registered practice location: Redmond, OR. NPI enumeration date: Jun 22, 2006. NPPES status: Active. The NPI Registry lists credential: CRNA.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Redmond, OR

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Redmond, OR address.

Christopher G Putnam Individual Program Crime
Redmond, OR · Conviction of program-related crimes · Excluded Nov 2024
Carol Fullerton Individual Program Crime
Redmond, OR · Conviction of program-related crimes · Excluded Oct 2015
Sheron Mullins Individual Program Crime
Redmond, OR · Conviction of program-related crimes · Excluded Sep 2015
Rosa Lorraine Amis Individual Revocation
Redmond, OR · License revocation, suspension, or surrender · Excluded Dec 2013
Sharon Gail Souders Individual Patient Abuse
Redmond, OR · Conviction relating to patient abuse or neglect · Excluded Apr 2010

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

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Related

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