Andrea Wallace, FNP-C in Olive Branch, MS - Medicare Nurse Practitioner

Andrea Wallace, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Olive Branch, Mississippi. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Stern Cardiovascular Foundation, Inc, Specialty Physician Group Llc, Stern Cardiovascular Foundation, Inc and her current practice location is 5041 Goswell Cv, Olive Branch, Mississippi. You can reach out to her office (for appointments etc.) via phone at (901) 517-2555.

Andrea Wallace is licensed to practice in Tennessee (license number 30782) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1497414213.

Contact Information

	Andrea Wallace, FNP-C
	5041 Goswell Cv, Olive Branch, MS 38654-9189
	(901) 517-2555
	Not Available

Map and Direction

Provider's Profile

Full Name	Andrea Wallace
Gender	Female
Speciality	Nurse Practitioner
Experience	3 Years
Location	5041 Goswell Cv, Olive Branch, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Andrea Wallace graduated from nursing school in 2021

NPI Data:

NPI Number: 1497414213
Provider Enumeration Date: 12/09/2021
Last Update Date: 07/06/2023

Medicare PECOS Information:

PECOS PAC ID: 7315332772
Enrollment ID: I20220322000379

Medical Identifiers

Medical identifiers for Andrea Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497414213	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	30782 (Tennessee)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Baptist Memorial Hospital	Memphis, TN	Hospital
Baptist Memorial Hospital Desoto	Southaven, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Stern Cardiovascular Foundation, Inc	8123200540	101
Specialty Physician Group Llc	9537291323	93
Stern Cardiovascular Foundation, Inc	8123200540	101

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Andrea Wallace allows following entities to bill medicare on her behalf.

Entity Name	Specialty Physician Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174842181 PECOS PAC ID: 9537291323 Enrollment ID: O20100714000297

Entity Name	Stern Cardiovascular Foundation, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316242266 PECOS PAC ID: 8123200540 Enrollment ID: O20110310000278

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andrea Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Andrea Wallace, FNP-C 5041 Goswell Cv, Olive Branch, MS 38654-9189 Ph: (901) 517-2555	Andrea Wallace, FNP-C 5041 Goswell Cv, Olive Branch, MS 38654-9189 Ph: (901) 517-2555

Reviews and Comments

Nurse Practitioner Nurses in Olive Branch, MS

Carolyn Wong, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4064 Sidlehill Dr, Olive Branch, MS 38654 Phone: 601-842-9006
Brittany Nikita Carper, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6674 Goodman Rd, Olive Branch, MS 38654 Phone: 662-985-7806
Jennifer C Sanders, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5480 Goodman Rd Ste 1, Olive Branch, MS 38654 Phone: 662-874-6507 Fax: 662-932-8197
Mrs. Misty Moore Ivy, C.R.N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7203 Goodman Rd, Olive Branch, MS 38654 Phone: 901-759-2322
Wanda Brown, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4240 Bethel Rd Ste 101, Olive Branch, MS 38654 Phone: 662-932-9544 Fax: 662-932-9554
Kori Swearengen, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9075 Sandidge Center Cv, Olive Branch, MS 38654 Phone: 662-895-4949 Fax: 662-895-6776
Queen Mcghee, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4250 Bethel Rd, Olive Branch, MS 38654 Phone: 662-932-9111

Andrea Wallace, FNP-C - Medicare Nurse Practitioner in Olive Branch, MS