Cherry Wallace, FNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2025047590 Issued in MO

Practice address

425 N New Ballas Rd Ste 203
Saint Louis, MO 63141-6848

Phone

(314) 872-3104

NPI assigned

Nov 3, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Physical Therapy Spine and Sports Medicine LLCGroup PAC ID 3173654936, 123 clinicians

Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BDDCDD/Endpoint/BDDCDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment Care Compare group NPD
• Signature Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1871542761
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MO

  Medicare reassignment NPD
• Physical Therapy Spine & Sports Medicine LLC

  • Rehabilitation Clinic/Center
  • Ballwin, MO
  • NPI 1942524087
  Care Compare group
• Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
  • NPI 1982473153
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1013886456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 CHESTNUT RIDGE RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630216925",
            "telephone_number": "314-536-1897",
            "fax_number": "314-536-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416848",
            "telephone_number": "314-872-3104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3009 N Ballas Rd Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312322",
            "country_code": "US",
            "telephone_number": "314-432-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 LeMay Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631252408",
            "country_code": "US",
            "telephone_number": "314-685-8721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHERRY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2025047590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace P Berkowitz MD LTD
• Andrew Blake Wallace, M.D.
• Angela Wallace, LPC
• Ashleigh Wallace, PHARMD
• Cassandra Marie Wallace, PNP
• Claire Wallace, PH.D.
• Colleen Maire Wallace, MD
• Darcie L Wallace, PA-C
• Erin Wallace
• Francene Wallace

• Gerontology Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.