Madison Wallace, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22760 Issued in TN

Practice address

1995 Highway 51 S Ste 204
Covington, TN 38019-3655

Phone

(901) 475-5305

Fax

(901) 475-5307

NPI assigned

Jul 18, 2017

Last updated

Apr 17, 2024By 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 names 1

• Madison Johnson Former name

Medicare fee-for-service enrollment

Enrolled in TN

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beacon Home Health Home health agency, Memphis, TN, CCN 447277
• Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Merit-based Incentive Payment System (MIPS)

Final score

85.88 of 100Reported as group

Quality

71.04

Promoting interoperability

100

Improvement activities

40

Cost

81.88

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206
  Medicare reassignment Care Compare group NPD
• The Little Clinic of Tennessee LLC

  • Family Nurse Practitioner
  • White House, TN
  • NPI 1487848800
  Medicare reassignment NPD
• Baptist Memorial Medical Group Inc

  dba BMG East Memphis Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD
• Pediatric Associates of West Tennessee PLLC

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1679929285

  Pediatrics

  NPD (past)

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

• Amedisys Tennessee, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Memphis, TN
  • NPI 1114975539
  Care Compare affiliation
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Baptist Memorial Hospital-Tipton

  • General Acute Care Hospital
  • Covington, TN
  • NPI 1316901937
  Care Compare affiliation

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1740703180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "901-227-7015",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 HIGHWAY 51 S STE 204",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193655",
            "telephone_number": "901-475-5305",
            "fax_number": "901-475-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MADISON",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-0093)
• Wal-Mart Stores East, LP (Vision Center 30-0093)
• Walgreen Co (Walgreens #07911)
• Walgreen Co (Rite Aid #7410)
• Kathleen Peterson Wallace, MA, CCC-SLP
• Tajuana A Wallace
• Michelle Washington, SLP-CCC
• Judy G Watkins, RN
• Mary Elaine Watkins
• Kelsi Ellen Watson, RN

• Family Nurse Practitioner in Covington, TN
• Providers in Covington, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.