Bonnie Wallace, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APN0000016620 Issued in TN

Practice address

4230 Harding Pike
Ste 330
Nashville, TN 37205-2013

Phone

(615) 269-4545

NPI assigned

May 30, 2012

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 TN, KY, GA3 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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bonnie.wallace.1@22854.direct.athenahealth.com

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.

• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1134739089

  KY

  Medicare reassignment NPD
• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1255930228

  GA

  Medicare reassignment

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1770844300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE",
            "address_2": "STE 330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052013",
            "telephone_number": "615-269-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE",
            "address_2": "STE 330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052013",
            "telephone_number": "615-269-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BONNIE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "APN0000016620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savanna Wall
• Shelley Wall, SA-C
• Allison Wallace, LPC-MHSP
• Angelina Victoria Wallace
• Anna Beamer Wallace, RN
• Cristin McPherson Wallace, DDS
• David K. Wallace, MD
• Deborah Elaine Wallace, F.N.P.
• Douglas Wallace, M.D.
• Elizabeth Wallace

• Adult Health Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Adult Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.