Laura Ann Wallace, A.P.N

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2010037004 Issued in MO

Practice address

301 N Highway 21
Pilot Knob, MO 63663-7862

Phone

(573) 546-8036

Fax

(573) 546-8067

NPI assigned

Jan 14, 2011

Last updated

Aug 7, 2025By the provider in NPPES

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 TN, MO2 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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iron County Hospital DistrictGroup PAC ID 0941207526, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iron County Medical Center Hospital, Pilot Knob, MO, CCN 261336

Merit-based Incentive Payment System (MIPS)

Final score

67.5 of 100Reported as group

Quality

53.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: laura.wallace.1@16878.direct.athenahealth.com

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

• Iron County Hospital District

  dba Iron County Medical Center

  • Critical Access Hospital
  • Pilot Knob, MO
  • NPI 1477648178
  Medicare reassignment Care Compare group
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Family

  NPD
• Iron County Hospital District

  dba Iron County Hospital Family Care Clinic

  • Rural Health Clinic/Center
  • Pilot Knob, MO
  • NPI 1073799367
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• West TN Medical, PLLC

  • Legal Medicine
  • Dyersburg, TN
  • NPI 1023053386
  NPD (past)

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

• Iron County Hospital District

  dba Iron County Medical Center

  • Critical Access Hospital
  • Pilot Knob, MO
  • NPI 1477648178
  Care Compare affiliation

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1265737753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N HIGHWAY 21",
            "city": "PILOT KNOB",
            "state": "MO",
            "postal_code": "636637862",
            "telephone_number": "573-546-8036",
            "fax_number": "573-546-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N HIGHWAY 21",
            "city": "PILOT KNOB",
            "state": "MO",
            "postal_code": "636637862",
            "telephone_number": "573-546-8036",
            "fax_number": "573-546-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "A.P.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2010037004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shepherd Mountain Emergency Physicians
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• Kylie Renee Strange, FNP
• True Care Home Health Equipment Sales and Service LLC
• Kathern Marie Twidwell, RDH
• Michelle Whited, RN
• Worden Chiropractic and Health
• Joseph Donald Worden III, D.C.

• Primary Care Nurse Practitioner in Pilot Knob, MO
• Providers in Pilot Knob, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.