Suzanne Beth Wallace, APRN,BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

3054-033 Issued in WI

Practice address

2500 Overlook Ter
Madison, WI 53705-2254

Phone

(608) 256-1901

NPI assigned

Apr 3, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265554240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 VAN HISE AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537264053",
            "telephone_number": "608-236-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 OVERLOOK TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052254",
            "telephone_number": "608-256-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SUZANNE",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "APRN,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "3054-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Wallace, MS, RD
• Franklyn Keith Ramsey Wallace, MD
• Katherine J Wallace, NATUROPATH
• Savannah Wallace, FNP-BC, APNP
• Sumer Kay Wallace, MD
• Tara Wallace
• Ellis P Waller Jr., MD
• Kenneth Russell Waller III, DVM, MS
• Thomas R Waller
• Thomas R Wallhaus, MD

• Adult Health Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Adult Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.