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ANDREA WALLACE FNP-C
NPI 1497414213
Nurse Practitioner - Family in Olive Branch, MS

Active since December 09, 2021PECOS EnrolledAccepts Medicare Assignment
5041 GOSWELL CV, OLIVE BRANCH, MS 38654(901) 517-2555 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 6, 2023, Dec 9, 2021 (2 updates tracked since 2021).

About Andrea Wallace Fnp-c NPPES

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

ANDREA WALLACE FNP-C (NPI 1497414213) is an individual family provider in Olive Branch, Mississippi, licensed in Tennessee (30782) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS, is affiliated with Baptist Memorial Hospital North Ms, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1497414213
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANDREA WALLACECredential: FNP-C
Location Address5041 GOSWELL CVOlive Branch, MS 38654-9189
Mailing Address5041 Goswell CvOlive Branch, MS 38654-9189 · (901) 517-2555
Phone(901) 517-2555
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 9, 2021
Last NPPES UpdateJuly 6, 20232 updates tracked since enumeration
NPPES CertifiedJuly 6, 2023
✔ NPI 1497414213 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 30782
5041 GOSWELL CV, Olive Branch, MS 38654
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, BlueCross BlueShield of Tennessee, Cigna Healthcare and more.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

Andrea Wallace Fnp-c 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.

PECOS PAC ID7315332772
PECOS Enrollment IDI20220322000379, I20240610002634, I20250110002833
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Andrea Wallace reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Specialty Physician Group LLC
14 mi
Cardiovascular Disease
7460 WOLF RIVER BLVD
Germantown, TN 38138
  • Reassigned Medicare billing, Tennessee enrollment
  • 122 clinicians in this Medicare group
NPI 1174842181 (901) 763-0200
Stern Cardiovascular Center, PA
14 mi
Cardiovascular Disease
8060 WOLF RIVER BLVD
Germantown, TN 38138
  • Reassigned Medicare billing, Arkansas, Mississippi and Tennessee enrollments
  • 16 clinicians in this Medicare group
NPI 1699790311 (901) 271-2272
Stern Cardiovascular Foundation, Inc
14 mi
Cardiovascular Disease
8060 WOLF RIVER BLVD
Germantown, TN 38138
  • Reassigned Medicare billing, Arkansas, Mississippi and Tennessee enrollments
  • 13 clinicians in this Medicare group
NPI 1316242266 (901) 271-1000

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 3

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
61 services44 patients
Evaluation of lower heart chamber assist device 93750
An evaluation of a lower heart chamber assist device is a procedure to check the function of an implanted device aiding your heart's lower chambers. This helps ensure optimal heart function by monitoring the device's performance and your heart's response to it.
36 services23 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Memorial Hospital North Ms

Acute Care Hospitals · Oxford, MS
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number250034
Location1100 Belk Blvd /Po Box 946Oxford, MS 38655 · Lafayette County
Emergency services Birthing friendly

Baptist Memorial Hospital Desoto

Acute Care Hospitals · Southaven, MS
1/5 CMS rating
OwnershipProprietary
CMS Certification Number250141
Location7601 Southcrest ParkwaySouthaven, MS 38671 · De Soto County
Emergency services Birthing friendly

Baptist Memorial Hospital

Acute Care Hospitals · Memphis, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440048
Location6019 Walnut Grove RoadMemphis, TN 38120 · Shelby County
Emergency services Birthing friendly

Baptist Memorial Hospital Tipton

Acute Care Hospitals · Covington, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440131
Location1995 Highway 51 SCovington, TN 38019 · Tipton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Andrea Wallace's NPI number?

The NPI number for Andrea Wallace is 1497414213. It was assigned to this individual provider in the NPPES registry on December 9, 2021.

Where is Andrea Wallace located?

Andrea Wallace practices at 5041 Goswell Cv, Olive Branch, MS 38654. The listed phone number is (901) 517-2555.

What is Andrea Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Andrea Wallace enrolled in Medicare?

Yes. Andrea 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 organizations bill Medicare for Andrea Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Wallace reassigns Medicare benefits to 3 organizations: Specialty Physician Group LLC (Germantown, TN), Stern Cardiovascular Center, PA (Germantown, TN) and Stern Cardiovascular Foundation, Inc (Germantown, TN). Each 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 Andrea Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrea Wallace accept?

Health plans from Blue Cross and Blue Shield of Alabama, BlueCross BlueShield of Tennessee, Cigna Healthcare, Health Advantage and Octave and 3 other insurers list Andrea 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.

Is Andrea Wallace affiliated with any hospitals?

According to CMS data, Andrea Wallace is affiliated with Baptist Memorial Hospital North Ms, Baptist Memorial Hospital Desoto, Baptist Memorial Hospital and Baptist Memorial Hospital Tipton.

When was this NPI record last updated?

The NPPES record for Andrea Wallace was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.