Terri Wallace, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

21186 Issued in TN

Practice address

1056 E Raines Rd
Memphis, TN 38116-6337

Phone

(901) 300-5777

Fax

(901) 422-6092

NPI assigned

Apr 28, 2016

Last updated

Jul 18, 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 3

Addresses

Other names 1

• Terri Basken Former name

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Physicians Group of Tennessee, PLLCGroup PAC ID 5597187088, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Dedicated Physicians Group of Tennessee, PLLC

  dba Dedicated Senior Medical Center

  • Non-Pharmacy Dispensing Site
  • Miami, FL
  • NPI 1174144695

  TN

  Medicare reassignment Care Compare group NPD
• Carr PLLC

  dba Sound Physicians Emergency of Greater Memphis

  • Emergency Medicine Physician
  • Brentwood, TN
  • NPI 1548677610
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361

  Nurse Practitioner

  Medicare reassignment NPD
• Curana Health of Tennessee LLC

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1750761060
  Medicare reassignment NPD
• Germantown Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Germantown, TN
  • NPI 1518747526
  Medicare reassignment NPD
• Methodist North Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1801677083
  Medicare reassignment NPD
• Methodist South Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1609657873
  Medicare reassignment NPD
• Methodist University Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1023899291
  Medicare reassignment NPD
• T M Carr MD PC

  • Emergency Medicine Physician
  • Dyersburg, TN
  • NPI 1992706097

  Nurse Practitioner

  Medicare reassignment NPD
• Olive Branch Emergency Physicians LLC

  • Emergency Medicine Physician
  • Olive Branch, MS
  • NPI 1730969734
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  dba UMMC Greenwood Hospital

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  dba Urgent Team

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

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1356796262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 E RAINES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166337",
            "telephone_number": "901-300-5777",
            "fax_number": "901-422-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 E RAINES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166337",
            "telephone_number": "901-300-5777",
            "fax_number": "901-422-6092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Poplar Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381193974",
            "country_code": "US",
            "telephone_number": "901-625-5408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TERRI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "21186",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904130",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "BASKEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madison Wallace
• Marisha Wallace
• Michael C Wallace, MD
• Robert D Wallace, MD
• Sharon Denice Wallace
• William S Wallace, FNP
• Gwendolyn Felicia Waller-Moore, FNP
• Benjamin R Waller III, MD
• Lindsey Waller
• Sandra D Waller, FNP, MSN

• Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.