DR. CESALIE DEONNE WALLACE APN
NPI 1407104052
Nurse Practitioner - Family in Jacksonville, AR
About Dr. Cesalie Deonne Wallace Apn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CESALIE DEONNE WALLACE APN (NPI 1407104052) is an individual family provider in Jacksonville, Arkansas, licensed in Arkansas (A003758) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Little Rock, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Cesalie Deonne Wallace Apn 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.
Medicare Billing Reassignment
Medicare enrollment records show Cesalie Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North Little Rock, AR 72116
- Reassigned Medicare billing, Arkansas enrollment
- 2,038 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72076 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Cesalie Wallace's NPI number?
The NPI number for Cesalie Wallace is 1407104052. It was assigned to this individual provider in the NPPES registry on August 29, 2012. The provider is also known as Cesalie D Harriss.
Where is Cesalie Wallace located?
Cesalie Wallace practices at 3000 North First Street, Jacksonville, AR 72076. The listed phone number is (501) 982-7477.
What is Cesalie Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Cesalie Wallace enrolled in Medicare?
Yes. Cesalie 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.
Which organization bills Medicare for Cesalie Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Cesalie Wallace reassigns Medicare benefits to University Of Arkansas For Medical Sciences (North Little Rock, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Cesalie Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Cesalie Wallace accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Cesalie Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Cesalie Wallace was last updated on January 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Dr. Cesalie Deonne Wallace, APN · NPI 1407104052
Family physician in Jacksonville, Arkansas. Individual provider, active in the CMS NPPES registry since August 29, 2012.
## Identity
- **NPI:** 1407104052 (Entity type: Individual)
- **Enumerated:** August 29, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** A003758 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3000 NORTH FIRST STREET, Jacksonville, AR 72076
- **Phone:** (501) 982-7477
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Of Arkansas For Medical Sciences (NPI 1750456638, North Little Rock, AR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** January 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1407104052) · Data from the CMS NPPES public registry.