Leigh A Wallace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-100834 Issued in AL

Practice address

170 County Road 360
Florence, AL 35634-5252

Phone

(256) 335-5773

NPI assigned

Jan 21, 2021

Sex

Female

Sole proprietor

Yes

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 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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoals Primary Care, LLCGroup PAC ID 1557406246, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Shoals Primary Care, LLC

  • Family Medicine Physician
  • Sheffield, AL
  • NPI 1326373861

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• HH Health System - Shoals LLC

  • General Acute Care Hospital
  • Sheffield, AL
  • NPI 1508952235
  Care Compare affiliation

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1902496136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COUNTY ROAD 360",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356345252",
            "telephone_number": "256-335-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COUNTY ROAD 360",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356345252",
            "telephone_number": "256-335-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LEIGH",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-100834",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-100834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walker Dental PLLC
• E Earl Walker, M.D.
• Evins Wall, LPC
• Frank A. Wall, D.M.D.
• Lisa Catherine Sims Wallace, CRNP
• Shawn Terrell Walls, CRNA
• Watson Infusion Co., Inc
• Vicki Watson
• Wayne G. Stanley M.D., PC

• Family Nurse Practitioner in Florence, AL
• Providers in Florence, 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 15, 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.