Jasmia Nyree Wallace, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11002307 Issued in FL

Practice address

210 Athens Way Ste 200
Nashville, TN 37228-1308

Phone

(615) 270-3505

NPI assigned

Mar 2, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 15

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN, FL, CO, DE, CA, OR, IL, MD, PA, MI, KY, NY, MN14 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 14

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: jasmia.wallace@719647455969284.direct.elationemr.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Balboa Nephrology Medical Group, Inc.

  • Nephrology Physician
  • San Diego, CA
  • NPI 1316997505
  Medicare reassignment NPD
• Easy Health Medical Solutions PC

  • Nurse Practitioner
  • Fulton, MD
  • NPI 1972179141

  CO

  Medicare reassignment NPD
• Happy Health PLLC

  • Sleep Medicine (Internal Medicine) Physician
  • Saint Paul, MN
  • NPI 1326426818
  Medicare reassignment NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment NPD
• Nephrology Associates of Kentuckiana PSC

  • Nephrology Physician
  • Louisville, KY
  • NPI 1730161753
  Medicare reassignment NPD
• Nephrology Associates of Michigan PC

  • Nephrology Physician
  • Ypsilanti, MI
  • NPI 1922249366
  Medicare reassignment NPD
• Nephrology Associates PA

  • Nephrology Physician
  • Newark, DE
  • NPI 1407805203
  Medicare reassignment NPD
• Nephrology Clinic PC

  • Nephrology Physician
  • Fort Collins, CO
  • NPI 1942297742
  Medicare reassignment NPD
• Northwest Renal Clinic, Inc.

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
  • NPI 1164946984
  Medicare reassignment NPD
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Tualatin, OR
  • NPI 1679752273
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Gastroenterology Physician
  • Lancaster, PA
  • NPI 1043670805
  Medicare reassignment NPD
• Nephrology Associates of Central Florida, P.a.

  • Nephrology Physician
  • Longwood, FL
  • NPI 1346297173
  Medicare reassignment

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1932473386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ATHENS WAY STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ATHENS WAY STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281308",
            "telephone_number": "615-270-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 21st Ave S",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372032424",
            "country_code": "US",
            "telephone_number": "615-321-2590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1544 Bass Rd",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312107510",
            "country_code": "US",
            "telephone_number": "478-471-4494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JASMIA",
        "middle_name": "NYREE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025072",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3019056",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209027385",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0100636-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN217995",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1100729",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704401026",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353211",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16419",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11335",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC005558",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10011868",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028130",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012297",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David K. Wallace, MD
• Deborah Elaine Wallace, F.N.P.
• Douglas Wallace, M.D.
• Elizabeth Wallace
• Eric Joseph Wallace Jr., M.D.
• Jessica Lee Wallace, PHARM.D., BCPS
• Juliet Paige Wallace, PHARM.D.
• Karen Wallace
• Kathryn Wallace
• Matthew Wallace

• Family Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.