Dionne H Wallace, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A005504 Issued in AR

Practice address

1900 Club Manor Dr Ste 105
Maumelle, AR 72113-7443

Phone

(501) 851-8100

NPI assigned

Feb 9, 2018

Last updated

Mar 4, 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

Other names 1

• Dionne H Humphrey Former name

Medicare fee-for-service enrollment

Enrolled in AR

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Team of Arkansas Physicians LLCGroup PAC ID 1850539198, 155 clinicians

St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dionne.wallace@svmgs.eclinicaldirectplus.com
• Direct secure messaging: dwallace458801@direct.stlukeshealth.org

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.

• St. Vincent Medical Group

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134176480
  Medicare reassignment Care Compare group NPD
• Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Searcy, AR
  • NPI 1992041370
  Medicare reassignment Care Compare group
• St. Anthony's Hospital Association

  dba Morrilton Hospitalists Group

  • Hospitalist Physician
  • Morrilton, AR
  • NPI 1992137236

  Family

  Medicare reassignment NPD
• St. Anthonys Hospital Association

  • Emergency Medicine Physician
  • Morrilton, AR
  • NPI 1174916258
  NPD
• Arkansas Family Care Network

  • Family Medicine Physician
  • North Little Rock, AR
  • NPI 1497718134
  NPD (past)
• St Vincent Physician Clinics LLC

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134558398
  NPD (past)

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

• Baptist Health

  dba Baptist Health Medical Center-Little Rock

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • Home Delivered Meals
  • Hot Springs, AR
  • NPI 1033157375

  Hospital

  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Acute Care Hospital
  • Hot Springs, AR
  • NPI 1316144546
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Practice Physician
  • Hot Springs, AR
  • NPI 1497880124

  Hospital

  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • Psychiatric Hospital Unit
  • Hot Springs, AR
  • NPI 1619915949
  Care Compare affiliation
• CHI St Vincent Hospital Hot Springs

  • General Acute Care Hospital
  • Hot Springs, AR
  • NPI 1689628232
  Care Compare affiliation
• Mercy Hospital Hot Springs

  • Clinic/Center
  • Hot Springs, AR
  • NPI 1174705388

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1417456989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CLUB MANOR DR STE 105",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137443",
            "telephone_number": "501-224-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CLUB MANOR DR STE 105",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137443",
            "telephone_number": "501-851-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1016 N Fourche Ave",
            "address_purpose": "LOCATION",
            "city": "Perryville",
            "state": "AR",
            "postal_code": "721268545",
            "country_code": "US",
            "telephone_number": "501-238-1284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Highway 62 W",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "AR",
            "postal_code": "725768059",
            "country_code": "US",
            "telephone_number": "870-895-2015",
            "fax_number": "870-895-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DIONNE",
        "middle_name": "H",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIONNE",
            "last_name": "HUMPHREY",
            "middle_name": "H",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Vangilder, PHARMD
• Matthew Wagner, M.D.
• Walgreen Co (Walgreens #12418)
• Andrea Walker
• Lucus Austin Walker, QBHP
• Kaelee Wallace, PT, DPT
• Michele Leigh Walls, LMSW
• Lauren Ward
• Jessica Lynn Watt
• Katherine J Weiler, MSE-SLP

• Family Nurse Practitioner in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.