Tonia Wallace, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5020892 Issued in NC

Practice address

2818 Queen City Dr Ste E
Charlotte, NC 28208-2736

Phone

(623) 294-8804

NPI assigned

Feb 21, 2022

Last updated

Aug 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TN, NC3 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 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Eventus WH Southeast, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1487494811

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth, PLLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1548759392

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Eventus Value Care, LLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1013680503

  Single Specialty

  Medicare reassignment NPD
• Alliance Healthcare Services

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1295898393

  Single Specialty

  Medicare reassignment NPD
• Atr Integrated LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1952002214

  Single Specialty

  Medicare reassignment NPD
• Tailored Psychiatric Wellness Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1023872454
  Authorized official Same address or phone
• Alliance Healthcare Services

  dba Alliance Healthcare System Whitney Pharmacy

  • Clinic Pharmacy
  • Memphis, TN
  • NPI 1912312828
  NPD
• Community Bridges, Inc.

  dba West Valley Access Point

  • Community/Behavioral Health Agency
  • Avondale, AZ
  • NPI 1205115631
  NPD (past)
• Community Bridges, Inc.

  dba West Valley Outpatient Services Center

  • Community/Behavioral Health Agency
  • Avondale, AZ
  • NPI 1972364966
  NPD (past)

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786752000000",
    "number": "1700531498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N MICHIGAN AVE STE 810",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015902",
            "telephone_number": "623-294-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 QUEEN CITY DR STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082736",
            "telephone_number": "623-294-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TONIA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2026-08-15",
        "certification_date": "2026-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5020892",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "270985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert T Wallace, C.PED.
• Rubye Burks Wallace, RN
• Shana Dale Wallace, MD
• Sidiqat Wallace
• Terry W Wallace, M.D.
• Stephen Lee Wallenhaupt, MD
• Peter David Wallens, M.S.W.
• Hannah R Waller
• John Christian Waller, LPC
• Angela Wallick

• Psychiatric/Mental Health Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; 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.