Individual provider Active NPI

Ansleigh Morrow Wallace, FNP-BC

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1184140543
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21253 Issued in SC
Practice address
2145 Henry Tecklenburg Dr Ste 220
Charleston, SC 29414-5894
Phone
(843) 723-8823
Fax
(843) 606-8059
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21253 SC
Family Nurse Practitioner 363LF0000X 21253 SC Primary

Addresses

Primary practice location

2145 Henry Tecklenburg Dr Ste 220
Charleston, SC 29414-5894

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other practice location 1

3 Richland Medical Park Dr Ste 310
Columbia, SC 29203
Phone (803) 434-8323

Other identifiers 1

IdentifierTypeStateIssuer
NP5186MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20180629001236 SC Practitioner - Nurse Practitioner 8729334099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2145 Henry Tecklenburg Dr
Suite 220
Charleston, SC 29414-5894
Phone (843) 723-8823

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince May 8, 2023 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 8, 2023 Accepting new patients
Roper St. Francis Specialty Physicians Nurse Practitioner CurrentSince Feb 1, 2026 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

2145 Henry Tecklenburg Dr
Ste 220
Charleston, SC 29414
Phone (843) 958-2555

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

300 Callen Blvd
Ste 200
Summerville, SC 29486
Phone (843) 724-8823

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1184140543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 HENRY TECKLENBURG DR STE 220",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145894",
            "telephone_number": "843-723-8823",
            "fax_number": "843-606-8059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Richland Medical Park Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-8323",
            "fax_number": "803-434-8326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANSLEIGH",
        "middle_name": "MORROW",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5186",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.