Paige Marie Wallace

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP143787 Issued in TX

Practice address

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122

Phone

(817) 291-4545

NPI assigned

Dec 19, 2019

Last updated

Dec 19, 2019By 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 TX

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Gastroenterology Associates, PAGroup PAC ID 2264574649, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.7 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

72.33

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advanced Gastroenterology Associates, PA

  • Gastroenterology Physician
  • Decatur, TX
  • NPI 1003049032
  Medicare reassignment Care Compare group NPD
• Texas Health Virtual Care

  dba Texas Health Care at Home

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1942951199
  Medicare reassignment NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment NPD (past)
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1053767897
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Texas Health Virtual Care

  dba Texas Health Behavioral Health Video Visits

  • Psychiatry Physician
  • Mansfield, TX
  • NPI 1003507542
  NPD
• Accupath Lab LLC

  • Dermatopathology (Pathology) Physician
  • Decatur, TX
  • NPI 1609506575
  NPD (past)

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1326686403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-291-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "PAIGE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP143787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Webb Wallace, OTR
• Ashley Lynette Wallace, MSN, APRN, FNP-C,
• Bethany Wallace, LCSW
• Cristy L Wallace, FNP
• Gabriel Wallace
• Rafaella Izar Wallace, ANP
• Rane Perry Wallace, MS, LPC, LCDC, SAP
• Taron M Wallace, M.S., CCC-SLP
• Emily Wallen, MA, LPC
• Charles F. Waller, CRNA

• Acute Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.