Andrea S. Wall, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R0086862 Issued in OK

Practice address

10109 E 79TH St
Tulsa, OK 74133-4564

Phone

(918) 286-5131

Fax

(918) 249-7532

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea S. Wall Professional name

Medicare fee-for-service enrollment

Enrolled in OK, AR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awall283182@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  AR

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OK

  Medicare reassignment NPD
• Ahs Oklahoma Physician Group, LLC

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• Claremore Physicians LLC

  • Clinic/Center
  • Claremore, OK
  • NPI 1982692216
  NPD (past)

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

• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1043284292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-286-5131",
            "fax_number": "918-249-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-286-5131",
            "fax_number": "918-249-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "ANDREA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "NM",
            "license": "R31459",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "R0086862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "WALL",
            "middle_name": "S.",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sheila Walker
• Stacy Lea Walker, RD, LD
• Timothy Micheal Walker
• Yolanda J Walker, MS
• Timber Walkingstick
• Dawn Marie Wall, NP-C
• Adam Joseph Wallace, M.D.
• Alexa Nicole Wallace, MS, RD, LD
• Alyssa Ann Wallace
• Annette S. Wallace, LPC

• Acute Care Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Acute Care Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.