CHERRY WALLACE FNP
NPI 1013886456
Nurse Practitioner - Gerontology in Saint Louis, MO
About Cherry Wallace Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHERRY WALLACE FNP (NPI 1013886456) is an individual gerontology provider in Saint Louis, Missouri, licensed in Missouri (2025047590) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Cherry Wallace Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mercy Hospital St Louis
Acute Care Hospitals · Saint Louis, MOPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Cherry Wallace's NPI number?
The NPI number for Cherry Wallace is 1013886456. It was assigned to this individual provider in the NPPES registry on November 3, 2025.
Where is Cherry Wallace located?
Cherry Wallace practices at 425 N New Ballas Rd Ste 203, Saint Louis, MO 63141. The listed phone number is (314) 872-3104.
What is Cherry Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Cherry Wallace enrolled in Medicare?
Yes. Cherry Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Cherry Wallace affiliated with any hospitals?
According to CMS data, Cherry Wallace is affiliated with Mercy Hospital St Louis.
When was this NPI record last updated?
The NPPES record for Cherry Wallace was last updated on August 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Cherry Wallace, FNP · NPI 1013886456
Gerontology physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since November 3, 2025.
## Identity
- **NPI:** 1013886456 (Entity type: Individual)
- **Enumerated:** November 3, 2025
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 2025047590 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 425 N NEW BALLAS RD STE 203, Saint Louis, MO 63141-6848
- **Phone:** (314) 872-3104
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1013886456) · Data from the CMS NPPES public registry.