Melissa B Wallace, WHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

151045 Issued in MO

Practice address

111 Saint Lukes Center Dr Ste 44B
Chesterfield, MO 63017-3509

Phone

(143) 576-2424

Fax

(314) 576-2381

NPI assigned

Feb 8, 2012

Last updated

Feb 17, 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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West County Women's Healthcare, LLCGroup PAC ID 2961534417, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

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.

• West County Women's Healthcare, LLC

  • Obstetrics & Gynecology Physician
  • Chesterfield, MO
  • NPI 1447570395
  Medicare reassignment Care Compare group NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1760422265

  Nurse Practitioner

  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• St. Lukes Medical Group

  • Family Medicine Physician
  • Chesterfield, MO
  • NPI 1215308945
  NPD (past)

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

• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1497027247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SAINT LUKES CENTER DR STE 44B",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "143-576-2424",
            "fax_number": "314-576-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SAINT LUKES CENTER DR STE 44B",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "143-576-2424",
            "fax_number": "314-576-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MELISSA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "151045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #04220)
• Walgreen Co (Walgreens #07692)
• Walgreen Co (Walgreens #07185)
• Kelsie Marie Walker, PT
• Lindley B Wall, MD
• Patricia J Wallace
• Erin Wallinger-Smith, MS,CCC-SLP
• Mark P Walsma, M.D.
• Sarah E Walters
• Thomas Steven Walther, D.D.S.

• Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.