Karla Marie Wallace, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902985 Issued in MS

Practice address

314 Main St Ste B
Monticello, MS 39654-3702

Phone

(601) 587-4304

NPI assigned

Oct 24, 2018

Last updated

Apr 28, 2019By 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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier NP IncGroup PAC ID 9638421910, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19473/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/8246/brand/1/csg/1/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.

• Premier NP Inc

  • Family Nurse Practitioner
  • Talladega, AL
  • NPI 1063904977

  MS

  Medicare reassignment Care Compare group NPD
• Caring Hands Children's Clinic, LLC

  • Pediatric Registered Nurse
  • Monticello, MS
  • NPI 1578993267
  Medicare reassignment NPD
• Caring Hands Family Practice, LLC

  • Primary Care Nurse Practitioner
  • Monticello, MS
  • NPI 1861959256
  Medicare reassignment NPD

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556409600000",
    "number": "1740757145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MAIN ST STE B",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396543702",
            "telephone_number": "601-587-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MAIN ST STE B",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396543702",
            "telephone_number": "601-587-4304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2824 Dena Ln SW",
            "address_purpose": "LOCATION",
            "city": "Bogue Chitto",
            "state": "MS",
            "postal_code": "396296000",
            "country_code": "US",
            "telephone_number": "601-320-2096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KARLA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2019-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Joyce Thomas, FNP-C, ACNP
• Suzanne M Thompson, BCMHC
• TLC Personal Care Services LLC
• Genie B Vaughan, RN, CFNP
• Belinda Waldrop, RN
• Joe A Ward, M.D.
• Katelyn White
• Brandy Carr Wilson, FNP

• Family Nurse Practitioner in Monticello, MS
• Providers in Monticello, 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 Apr 28, 2019; 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.