Cyneiceya Annette Wallace, MSN, APRN, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

906657 Issued in MS

Practice address

1401 River Rd
Greenwood, MS 38930-4030

Phone

(662) 459-7000

NPI assigned

May 14, 2024

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 MS

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

Yazoo Emergency Group, LLCGroup PAC ID 0749511574, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cyneiceya.wallace.p1@direct.glh.nextgenshare.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.

• Yazoo Emergency Group, LLC

  • Emergency Medicine Physician
  • Yazoo City, MS
  • NPI 1447806914
  Medicare reassignment Care Compare group NPD
• Attala Emergency Group LLC

  • Emergency Medicine Physician
  • Kosciusko, MS
  • NPI 1407103294
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Medicare reassignment NPD
• Central Mississippi Radiology

  • Specialist
  • Greenwood, MS
  • NPI 1275725590
  NPD
• Greenwood Leflore Hospital

  • Emergency Medicine Physician
  • Greenwood, MS
  • NPI 1861670911
  NPD
• Sunder Jagwani MD PA

  • Body Imaging Physician
  • Greenwood, MS
  • NPI 1033318985
  NPD

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

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Care Compare affiliation

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1972352821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 KEESLER ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389303216",
            "telephone_number": "662-299-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CYNEICEYA",
        "middle_name": "ANNETTE",
        "credential": "MSN, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "906657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Walker
• Courtney Walker, PHARMD
• John H Walker Jr., R.P.T.
• John Huff Walker III, NBCOT
• Robert Christopher Walker, PT, DPT
• Walnut Creek Emergency Group, LLC
• Walnut Creek Physician Services, LLC
• Jacqueline Suszan Ware, FNP
• Mildred B Ware, LPC
• Janice Watkins

• Adult Health Nurse Practitioner in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.
• 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.