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KELLI ANN WALLACE NP
NPI 1558009936
Nurse Practitioner - Family in Danville, VA

Active since May 25, 2022PECOS Enrolled
101 HOLBROOK ST, DANVILLE, VA 24541(434) 792-7765 Get Directions Write a Review

NPPES record last updated: May 25, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelli Ann Wallace Np NPPES

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

KELLI ANN WALLACE NP (NPI 1558009936) is an individual family provider in Danville, Virginia, licensed in Virginia (0024184388) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558009936
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLI ANN WALLACECredential: NP
Location Address101 HOLBROOK STDanville, VA 24541-1759
Mailing Address101 Holbrook StDanville, VA 24541-1759
Phone(434) 792-7765
Sole ProprietorNo
Enumeration DateMay 25, 2022
NPPES CertifiedMay 25, 2022
✔ NPI 1558009936 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 VA · 0024184388
101 HOLBROOK ST, Danville, VA 24541
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelli Ann Wallace Np 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.

Medicare Billing Reassignment

Medicare enrollment records show Kelli Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Universal Health Corporation
56 mi
Internal Medicine
130 CHURCH AVE SW
Roanoke, VA 24011
  • Reassigned Medicare billing, Virginia enrollment
  • 194 clinicians in this Medicare group
NPI 1407117625 (540) 769-3964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24541 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

Other Providers at the Same Location NPPES 16

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

INTERNAL MEDICINE ASSOCIATES LTD
Internal Medicine
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-4041
DR. ALICE B. NEWELL MD
Obstetrics & Gynecology
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-7765
OB-GYN ASSOCIATES OF DANVILLE
Specialist
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-7765
PHILLIP J HONEA D.O.
Obstetrics & Gynecology
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-7765
DANIELLE MARIE MERRICKS FNP
Nurse Practitioner (Family)
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-4041
DR. DOUGLAS W SHIFLETT MD
Internal Medicine (Gastroenterology)
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-4041
MRS. PHYLLIS T MCCORMICK RNC-OGNP
Nurse Practitioner (Obstetrics & Gynecology)
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-7765
DR. JASON L ENSMINGER M.D.
Obstetrics & Gynecology
101 HOLBROOK ST
DANVILLE, VA 24541
Danville City (434) 792-7765

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 Kelli Wallace's NPI number?

The NPI number for Kelli Wallace is 1558009936. It was assigned to this individual provider in the NPPES registry on May 25, 2022.

Where is Kelli Wallace located?

Kelli Wallace practices at 101 Holbrook St, Danville, VA 24541. The listed phone number is (434) 792-7765.

What is Kelli Wallace's specialty?

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

Is Kelli Wallace enrolled in Medicare?

Yes. Kelli Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelli Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelli Wallace reassigns Medicare benefits to Universal Health Corporation (Roanoke, VA). 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 Kelli Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelli Wallace was last updated on May 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.