Kelli Ann Wallace, NP in Danville, VA - Medicare Nurse Practitioner

Kelli Ann Wallace, NP is a medicare enrolled "Nurse Practitioner - Family" in Danville, Virginia. Her current practice location is 101 Holbrook St, Danville, Virginia. You can reach out to her office (for appointments etc.) via phone at (434) 792-7765.

Kelli Ann Wallace is licensed to practice in Virginia (license number 0024184388) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558009936.

Contact Information

	Kelli Ann Wallace, NP
	101 Holbrook St, Danville, VA 24541-1759
	(434) 792-7765
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelli Ann Wallace
Gender	Female
Speciality	Nurse Practitioner - Family
Location	101 Holbrook St, Danville, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558009936
Provider Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022

Medicare PECOS Information:

PECOS PAC ID: 1456715119
Enrollment ID: I20230913002525

Medical Identifiers

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

Identifier	Type	State	Issuer
1558009936	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	0024184388 (Virginia)	Primary

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. Kelli Ann Wallace allows following entities to bill medicare on her behalf.

Entity Name	Universal Health Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407117625 PECOS PAC ID: 5597912626 Enrollment ID: O20120824000538

Entity Name	Pai Participant 1 Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093371312 PECOS PAC ID: 8123351954 Enrollment ID: O20211208001934

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. Kelli Ann 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
Kelli Ann Wallace, NP 101 Holbrook St, Danville, VA 24541-1759 Ph: () -	Kelli Ann Wallace, NP 101 Holbrook St, Danville, VA 24541-1759 Ph: (434) 792-7765

Reviews and Comments

Nurse Practitioner Nurses in Danville, VA

Julie A Thompson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 414 Park Ave, Danville, VA 24541 Phone: 434-250-9471
Alvesha Akilah Williams, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 450 Piney Forest Rd, Danville, VA 24540 Phone: 540-345-3556
Allison Rae Bailey, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 142 S Main St, Danville, VA 24541 Phone: 434-799-2100
Mykayla Grace Kelley-montes, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 142 S Main St, Danville, VA 24541 Phone: 434-799-2100
Casey Sharp, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 949 Piney Forest Rd, Danville, VA 24540 Phone: 434-835-4876 Fax: 434-835-4875
Peggy P Cassada, ANP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 705 Piney Forest Rd, Danville, VA 24540 Phone: 434-710-4210
Mrs. Annette Easley Minter, AG-ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 501 Rison St Ste 120, Danville, VA 24541 Phone: 434-792-3730 Fax: 434-792-6048

Kelli Ann Wallace, NP - Medicare Nurse Practitioner in Danville, VA