Vicki Wallace, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

0024166526 Issued in VA

Practice address

1101 Sam Perry Blvd.,
Suite 211
Fredericksburg, VA 22401

Phone

(540) 372-7792

NPI assigned

Feb 24, 2006

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in VA

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Washington Healthcare PhysiciansGroup PAC ID 2769546530, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vwallace12065@marywashingtonhealthcare.direct-ci.com

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.

• Mary Washington Healthcare Physicians

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1295999852
  Medicare reassignment Care Compare group NPD
• Mary Washington Healthcare Physicians

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1740853035
  NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  NPD (past)

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

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1689640195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD",
            "address_2": "SUITE 211",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22401",
            "telephone_number": "540-372-7792",
            "fax_number": "540-372-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD.,",
            "address_2": "SUITE 211",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22401",
            "telephone_number": "540-372-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "VICKI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN67063",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024166526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084100",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405959000",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Walker, PTA
• Jessica Wallace
• Joey Andrew Wallace
• John Kline Wallace, DDS
• Lindsay Cole Wallace
• Carter Milan Waller, D.M.D.
• Leah Waller, PA-C
• Susan J Walley
• Michelle Walraven, CPHT
• Edward Gilbert Walsh, MD

• Acute Care Nurse Practitioner in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Acute Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.