Sierra Rose Wallace, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02473 Issued in KS

Practice address

1600 N Lorraine St Ste 202
Hutchinson, KS 67501-5600

Phone

(620) 663-7595

Fax

(620) 513-5098

NPI assigned

Aug 5, 2019

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

Medicare fee-for-service enrollment

Enrolled in KS

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

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Horizons Mental Health Center, Inc.Group PAC ID 2163418120, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Horizons Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Hutchinson, KS
  • NPI 1447354089
  Medicare reassignment Care Compare group
• Hutchinson Regional Medical Center, Inc.

  • Hospitalist Physician
  • Hutchinson, KS
  • NPI 1972605285
  Medicare reassignment

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1740835941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N LORRAINE ST STE 202",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675015600",
            "telephone_number": "620-663-7595",
            "fax_number": "620-513-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N LORRAINE ST STE 202",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675015600",
            "telephone_number": "620-663-7595",
            "fax_number": "620-513-5098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 E Market Ave",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721495615",
            "country_code": "US",
            "telephone_number": "501-279-5642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SIERRA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02473",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody J Wagler, LSCSW
• Lily Wakim, DDS
• Waldron Street Emergency Physicians, LLC
• Walgreen Co
• Beulah M. Walker
• Walmart Inc.
• Walmart Inc.
• Cheryl Diane Walter, CRNA
• Krystal Walton, PHARMD
• Howard Michael Wamsley, DDS

• Physician Assistant in Hutchinson, KS
• Providers in Hutchinson, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.