JENNIFER LYNN WALLACE
NPI 1326877622
Student in an Organized Health Care Education/Training Program in Memphis, TN

Q: What is Jennifer Wallace's NPI number?

The NPI number for Jennifer Wallace is 1326877622. It was assigned to this individual provider in the NPPES registry on July 26, 2024.

Q: What is Jennifer Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Wallace was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since July 26, 2024PECOS Enrolled

920 MADISON AVE STE 447, MEMPHIS, TN 38103(901) 448-7635 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2026, Jul 26, 2024 (2 updates tracked since 2024).

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About Jennifer Lynn Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER LYNN WALLACE (NPI 1326877622) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326877622

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJENNIFER LYNN WALLACE

Location Address920 MADISON AVE STE 447Memphis, TN 38103-3438

Mailing Address920 Madison Ave Ste 447Memphis, TN 38103-3438 · (901) 448-7635

Phone(901) 448-7635

Sole ProprietorYes

Enumeration DateJuly 26, 2024

Last NPPES UpdateMay 12, 20262 updates tracked since enumeration

NPPES CertifiedMay 12, 2026

✔ NPI 1326877622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

920 MADISON AVE STE 447, Memphis, TN 38103

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Lynn Wallace is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID EDWARD ZIMMERHANZEL MD

Student in an Organized Health Care Education/Training Program