Spencer Riley Wallace, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-147129 Issued in AL

Practice address

713 Goodyear Ave
Gadsden, AL 35903-1156

Phone

(256) 492-4040

NPI assigned

Jun 1, 2020

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Male

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 AL

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

University of Alabama School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Urology Associates, P.C.Group PAC ID 0749254241, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverview Regional Medical Center Hospital, Gadsden, AL, CCN 010046
• Gadsden Regional Medical Center Hospital, Gadsden, AL, CCN 010040

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spencerwallace@cua.medalliesdirect.net

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.

• Clinical Urology Associates, P.C.

  • Urology Physician
  • Gadsden, AL
  • NPI 1952369860
  Medicare reassignment Care Compare group NPD
• Clinical Urology Associates, P.C.

  • Urology Physician
  • Jacksonville, AL
  • NPI 1396593323
  NPD
• Regional Hospitalists LLC

  • Internal Medicine Physician
  • Gadsden, AL
  • NPI 1477153021
  NPD
• Cilinical Urology Associates, P.C.

  dba Clinical Urology associates, P.C.

  • Urology Physician
  • Fort Payne, AL
  • NPI 1285409557
  NPD (past)
• Doctors Care Physicians PC

  • Clinic/Center
  • Gadsden, AL
  • NPI 1700802766
  NPD (past)

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

• Gadsden Regional Medical Center LLC

  dba Gadsden Regional Medical Center

  • General Acute Care Hospital
  • Gadsden, AL
  • NPI 1225081516
  Care Compare affiliation
• Prime Healthcare Services - Gadsden LLC

  dba Riverview Regional Medical Center

  • General Acute Care Hospital
  • Gadsden, AL
  • NPI 1992103857
  Care Compare affiliation
• Prime Healthcare Services Gadsden LLC

  dba Riverview Imaging Center

  • Radiology Clinic/Center
  • Gadsden, AL
  • NPI 1801294764

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1831713387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359570697",
            "telephone_number": "256-840-8181",
            "fax_number": "256-744-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 GOODYEAR AVE",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031156",
            "telephone_number": "256-492-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9524 US Highway 431",
            "address_purpose": "LOCATION",
            "city": "Albertville",
            "state": "AL",
            "postal_code": "359500106",
            "country_code": "US",
            "telephone_number": "256-492-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Medical Center Dr SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683420",
            "country_code": "US",
            "telephone_number": "256-492-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7063 Veterans Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pell City",
            "state": "AL",
            "postal_code": "351255114",
            "country_code": "US",
            "telephone_number": "256-492-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SPENCER",
        "middle_name": "RILEY",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-147129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Walker, PHARMD
• Laura Walker, CRNA
• Lewis Patterson Walker III, MD
• Lacey Renee Wall, OTR
• James N Wallace, MD
• Jamie Waller
• Vicki Jo Wallis, MD
• Anastasia Walloga, DO
• Anderson Jay Ward III, CCP
• Kristina Marie Warren, CRNP

• Family Nurse Practitioner in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.