Susan R Wallace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R852101 Issued in MS

Practice address

100 Methodist Blvd
Hattiesburg, MS 39402-1295

Phone

(601) 268-6738

NPI assigned

Aug 9, 2012

Last updated

Aug 10, 2012By 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

Medicare fee-for-service enrollment

Enrolled in MS

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gastrointestinal Associates PAGroup PAC ID 5294795241, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094

Merit-based Incentive Payment System (MIPS)

Final score

76.9 of 100Reported as group

Quality

47.44

Promoting interoperability

98

Improvement activities

40

Cost

77.24

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Gastrointestinal Associates, P.a.

  • Gastroenterology Physician
  • Flowood, MS
  • NPI 1093765604
  Medicare reassignment Care Compare group NPD
• Gastrointestinal Associates, P.a.

  • Gastroenterology Physician
  • Vicksburg, MS
  • NPI 1144412438
  NPD
• Gastrointestinal Associates, PA

  • Anesthesiology Physician
  • Flowood, MS
  • NPI 1326587304
  NPD
• Gi Alliance Anesthesia of Mississippi PLLC

  • Certified Registered Nurse Anesthetist
  • Flowood, MS
  • NPI 1780303446
  NPD

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

• Wesley Health System LLC

  dba Merit Health Wesley

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  Care Compare affiliation

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1740537687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METHODIST BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021295",
            "telephone_number": "601-268-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 METHODIST BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021295",
            "telephone_number": "601-268-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SUSAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R852101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Russell Walker, ATC
• Anna Christian Wall
• Crystal Nichole Wallace, NP-C
• Felder E Wallace, D.D.S.
• Gwendolyn Deane Wallace, MS-CF,SLP
• Erik Waller
• William Lowe Waller III, MD
• Patricia Ann Walley
• Robert Walley
• Walnut Square Pharmacy LLC (Walnut Square Pharmacy)

• Family Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.