Elizabeth Ann Wallace, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21538 Issued in TN

Practice address

2001 Laurel Ave Ste 105
Knoxville, TN 37916-1867

Phone

(865) 577-9247

Fax

(833) 908-2095

NPI assigned

Aug 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth A Blair Former name

Medicare fee-for-service enrollment

Enrolled in TN

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.wallace.p1@direct.orthotn.nextgenshare.com
• Direct secure messaging: elizabeth.wallace.1@20785.direct.athenahealth.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.

• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group
• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1255410478
  NPD
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1699722470
  NPD (past)

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

• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1982159356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091382",
            "telephone_number": "865-584-4747",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161867",
            "telephone_number": "865-577-9247",
            "fax_number": "833-908-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21538",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "21538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BLAIR",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachal Wall
• Ruth Wall, PTA
• Susan M Wall, DNP, APRN, FNP-BC
• Anna Hollmann Wallace, M.D.
• Aundrea Leighann Wallace
• Heather Ann Wallace
• James Ryan Wallace, CRNA
• Jeffery Wallace
• Jessica Wallace, MA, NCC
• Judy C Wallace

• Family Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, 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 Sep 6, 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.