Emerson Akalee Wallace, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R759298 Issued in MS

Practice address

1154 Cross Creek Dr
Saltillo, MS 38866-5777

Phone

(662) 840-8010

Fax

(662) 840-2656

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

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 MS

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Triangle Urgent Care LLCGroup PAC ID 7315197498, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Tupelo, MS, CCN 257303
• Baptist Home Care and Hospice North Mississippi Home health agency, Batesville, MS, CCN 257114
• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

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 and National Provider Directory roles.

• Golden Triangle Urgent Care LLC

  • Rural Health Clinic/Center
  • Starkville, MS
  • NPI 1346592045

  Family

  Medicare reassignment Care Compare group NPD
• Convenient Care Clinic, LLC

  • Family Nurse Practitioner
  • Horn Lake, MS
  • NPI 1851490841
  Medicare reassignment NPD
• Convenient Care Clinic, LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1073246773

  Family

  NPD
• Golden Triangle Urgent Care LLC

  • Rural Health Clinic/Center
  • West Point, MS
  • NPI 1104559806

  Family

  NPD

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

• Gilbert'S Home Health Agency, Inc.

  • Home Health Agency
  • Tupelo, MS
  • NPI 1972509099
  Care Compare affiliation
• LHCG Xcviii, LLC

  • Home Health Agency
  • Batesville, MS
  • NPI 1275068959
  Care Compare affiliation
• North Mississippi Medical Center, Inc.

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336251560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CR1810",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "38866",
            "telephone_number": "662-844-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 CROSS CREEK DR",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388665777",
            "telephone_number": "662-840-8010",
            "fax_number": "662-840-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "EMERSON",
        "middle_name": "AKALEE",
        "name_prefix": "Mr.",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R759298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117978",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty McCoy Thompson, PT
• Twincare Family Clinic
• Anna Kathryn Tyson, PTA
• Marcus E Ueltschey, MD
• Laura Beth Walden, M.S., CCC-SLP
• We Care Services, LLC
• Wecare Services, LLC
• Robert Leonard Welch, PHARM. D.
• Jonathan White, FNP
• Shemeka Williams

• Family Nurse Practitioner in Saltillo, MS
• Providers in Saltillo, MS by specialty
• Family Nurse Practitioner in Mississippi

• 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.
• 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.