William S Wallace, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2475 Issued in WI

Practice address

1100 Gateway CT
West Bend, WI 53095-8539

Phone

(262) 335-8600

NPI assigned

Mar 3, 2006

Last updated

Jun 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, KS2 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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.wallace@directsbamh.org
• Direct secure messaging: wwallace375704@direct.myadvocateaurora.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.

• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Susan B. Allen Memorial Hospital

  • General Practice Physician
  • El Dorado, KS
  • NPI 1164554820
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1659599157
  NPD
• Susan B. Allen Memorial Hospital

  dba SBA Urgent Care Clinic

  • Urgent Care Clinic/Center
  • El Dorado, KS
  • NPI 1588156574
  NPD
• Columbia St Mary's Hospital Ozaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Multi-Specialty Clinic/Center
  • Mequon, WI
  • NPI 1376582775
  NPD (past)
• Pratt Family Practice LLC

  dba Pratt Family Practice

  • Rural Health Clinic/Center
  • Pratt, KS
  • NPI 1346379625
  NPD (past)

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

• Aurora Medical Center of Washington County, Inc.

  • General Acute Care Hospital
  • Hartford, WI
  • NPI 1760420103
  Care Compare affiliation
• Aurora Medical Center of Washington County, Inc.M

  • Clinic/Center
  • Hartford, WI
  • NPI 1306056056

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1467429860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GATEWAY CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958539",
            "telephone_number": "262-335-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Central Ave",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "KS",
            "postal_code": "670422184",
            "country_code": "US",
            "telephone_number": "316-322-9813",
            "fax_number": "316-322-9806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2475",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "KS44943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36030600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1100 Gateway Ct",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530958539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tanya Marie Wald, ATR, LPC
• Angela R Waldoch, M.S.
• Walgreen Co (Walgreens #13088)
• Walgreen Co (Walgreens #13683)
• Gabrielle Walker, RN
• Teneil Walters
• Nicolette Wamsley, HIS
• Katlynn Elizabeth Warder
• Tami Warnecke
• Lisa M Warren

• Nurse Practitioner in West Bend, WI
• Providers in West Bend, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.