Mr Wallace Dale Fox Jr, APRN - Medicare Nurse Practitioner in Clarksville, IN

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Mr Wallace Dale Fox Jr, APRN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Clarksville, Indiana. His current practice location is 1400 Main St Unit 177, Clarksville, Indiana. You can reach out to his office (for appointments etc.) via phone at (812) 946-2674.

Mr Wallace Dale Fox Jr is licensed to practice in Indiana (license number 71007238A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043731615.

Contact Information

Mr Wallace Dale Fox Jr, APRN
1400 Main St Unit 177,
Clarksville, IN 47129-3108
(812) 946-2674
(844) 832-9625

Map and Direction




Provider's Profile

Full NameMr Wallace Dale Fox Jr
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1400 Main St Unit 177, Clarksville, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1043731615
  • Provider Enumeration Date: 07/04/2017
  • Last Update Date: 12/19/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4981978525
  • Enrollment ID: I20170921000431

Medical Identifiers

Medical identifiers for Mr Wallace Dale Fox Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043731615NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 71007238A (Indiana)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 71007238A (Indiana)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. Mr Wallace Dale Fox Jr allows following entities to bill medicare on his behalf.
Entity NameThe Dermatology Center,psc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033142773
PECOS PAC ID: 2769422997
Enrollment ID: O20050506000676
Entity NameMindbranch Mental Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801675491
PECOS PAC ID: 7810348158
Enrollment ID: O20240110004466

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. Mr Wallace Dale Fox Jr 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 AddressPractice Location Address
Mr Wallace Dale Fox Jr, APRN
1400 Main St Unit 177,
Clarksville, IN 47129-3108

Ph: (812) 946-2674		Mr Wallace Dale Fox Jr, APRN
1400 Main St Unit 177,
Clarksville, IN 47129-3108

Ph: (812) 946-2674

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.