CRYSTAL NICHOLE WALLACE NP-C
NPI 1629550496
Nurse Practitioner in Hattiesburg, MS

Active since August 29, 2018PECOS EnrolledAccepts Medicare Assignment
7148 U S HIGHWAY 98 STE 102, HATTIESBURG, MS 39402(601) 475-8270(769) 207-6209 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 2, 2025, Apr 16, 2024, Aug 29, 2018 (3 updates tracked since 2018).

About Crystal Nichole Wallace Np-c NPPES

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

CRYSTAL NICHOLE WALLACE NP-C (NPI 1629550496) is an individual nurse practitioner in Hattiesburg, Mississippi, licensed in Mississippi (902669) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1629550496
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCRYSTAL NICHOLE WALLACECredential: NP-C
Location Address7148 U S HIGHWAY 98 STE 102Hattiesburg, MS 39402-9133
Mailing Address3 Carrington CtHattiesburg, MS 39402-8114 · (601) 810-8996
Fax(769) 207-6209
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 29, 2018
Last NPPES UpdateJune 2, 20253 updates tracked since enumeration
NPPES CertifiedJune 2, 2025
NPI 1629550496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in MS · 902669
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
7148 U S HIGHWAY 98 STE 102, Hattiesburg, MS 39402

Secondary Practice Locations 2

Location 1106 Asbury CirHattiesburg, MS 39402-1302 · Phone (601) 268-8698
Location 250 Parkway Ln Ste BPetal, MS 39465-3035 · Phone (601) 705-2897

Accepted Insurance

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

Crystal Nichole Wallace Np-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 ID1759625460
PECOS Enrollment IDI20181206003458
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.

Areas of Expertise CMS Part B claims 19

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 low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
252 services232 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
240 services34 patients
Injection, ceftriaxone sodium, per 250 mg J0696
Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.
180 services44 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.
129 services125 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
98 services80 patients
Analysis for antibody to mycoplasma (bacteria) 86738
This is a test to detect antibodies in your body that fight against mycoplasma, a type of bacteria. The test involves a simple blood draw. It helps in diagnosing infections caused by mycoplasma and guiding appropriate treatment.
81 services81 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39402 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.

Other Providers at the Same Location NPPES 3

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

Family Medicine
7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402
Nurse Practitioner (Family)
7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402
Nurse Practitioner
7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402

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 Crystal Wallace's NPI number?

The NPI number for Crystal Wallace is 1629550496. It was assigned to this individual provider in the NPPES registry on August 29, 2018.

Where is Crystal Wallace located?

Crystal Wallace practices at 7148 U S Highway 98 Ste 102, Hattiesburg, MS 39402. The listed phone number is (601) 475-8270.

What is Crystal Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Crystal Wallace enrolled in Medicare?

Yes. Crystal 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.

What insurance does Crystal Wallace accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Crystal 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 Crystal Wallace was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.