Laura Wallace, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2529872 Issued in FL

Practice address

455 Pinellas St
Suite #400
Clearwater, FL 33756-3354

Phone

(727) 445-1911

Fax

(727) 445-1986

NPI assigned

Jun 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

University of South Florida College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Florida Cardiology Network, LLCGroup PAC ID 8729260641, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/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.

• West Florida Cardiology Network, LLC

  • Cardiovascular Disease Physician
  • Saint Petersburg, FL
  • NPI 1801198023
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1144262197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 TALL PINE CIR",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346955204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PINELLAS ST",
            "address_2": "SUITE #400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563354",
            "telephone_number": "727-445-1911",
            "fax_number": "727-445-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN2529872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308800600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James D Walker, PTA
• Joyce Lynn Walker, LMHC
• Stacy E Walker, D.C.
• David Michael Wall, MD
• Cassandra Ann Wallace-Wical, ARNP
• Matthew A Wallace
• Paul R. Wallace, M.D.
• Richard Peterkin Wallace, M.D.
• Walmart Pharmacy
• Christopher Walsh, MA

• Nurse Practitioner in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.