Caroline Wallace

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5014470 Issued in NC

Practice address

101 Cabarrus Ave E
Concord, NC 28025-3699

Phone

(888) 849-7379

NPI assigned

May 27, 2021

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 NC

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, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Lower Cape Fear Hospice IncorporatedGroup PAC ID 3375445190, 26 clinicians

Lifecare Supportive Medicine IncorporatedGroup PAC ID 5092284182, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwallace1581208@direct.novanthealth.org

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.

• Lower Cape Fear Hospice, Incorporated

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wilmington, NC
  • NPI 1790258234
  Medicare reassignment Care Compare group NPD
• Lifecare Supportive Medicine Incorporated

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wilmington, NC
  • NPI 1316804446
  Medicare reassignment Care Compare group
• Liberty Healthcare Group, LLC

  • Case Management Agency
  • Wilmington, NC
  • NPI 1629217856
  Medicare reassignment NPD
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Falcon, NC
  • NPI 1912040379
  NPD
• Lower Cape Fear Hospice Incorporated

  • Case Management Agency
  • Wilmington, NC
  • NPI 1669012563
  NPD
• Lower Cape Fear Hospice Incorporated

  • Community Based Hospice Care Agency
  • Wilmington, NC
  • NPI 1912962697
  NPD (past)

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

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1962078295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5014470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walkers Home Care
• Bonnie L Wall
• Donna W Wall, CRNA
• James Wall, MD
• Randy Lee Wall, LPC, NCC
• Jakeyla Wallace
• Jennifer Leigh Wallace, PHARM D
• Tamera Waller-Drye
• Carly Lynne Waller, CNM
• Laura Elizabeth Waller

• Adult Health Nurse Practitioner in Concord, NC
• Providers in Concord, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.