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

Q: 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.

Q: What is Crystal Wallace's specialty?

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

Q: 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 16 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 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: October 25, 2026.

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

On this page

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

Phone(601) 475-8270

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

Open in Google Maps ↗

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

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Molina Healthcare, UnitedHealthcare.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

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.

Medicare Billing Reassignments

Medicare enrollment records show Crystal Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hattiesburg Clinic PA

6.0 mi

Family Medicine

104 MILLSAPS DR
Hattiesburg, MS 39402

Reassigned Medicare billing, Mississippi enrollment
696 clinicians in this Medicare group

NPI 1366539678 (601) 288-7500

Fast Pace Mississippi, PLLC

237 mi

Rural Health

517 CITY AVE S
Ripley, MS 38663

Reassigned Medicare billing, Mississippi enrollment
463 clinicians in this Medicare group

NPI 1447769559 (662) 587-8206

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 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

White blood cell count 85004

A white blood cell count is a blood test that measures the number of white blood cells in your body. These cells help fight infections. The test helps identify conditions like infections, inflammation, allergies, and diseases that affect the immune system.

80 services75 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

75 services74 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

61 services57 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

54 services53 patients

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique 87651

This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.

46 services45 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

35 services20 patients

Screening test for mononucleosis (mono) 86308

A screening test for mononucleosis, often known as 'mono', is a simple blood test. It checks for antibodies that your body produces when fighting the Epstein-Barr virus, the common cause of mono. This test helps confirm if symptoms like fatigue, sore throat, and fever are due to mono.

31 services31 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

26 services25 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

20 services20 patients

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc U0002

This refers to a test for COVID-19, caused by the SARS-CoV-2 virus. The test identifies multiple types or subtypes of the virus, including all targets. It's not specifically based on the CDC's testing protocol. It helps determine if you're currently infected with the virus.

20 services20 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

18 services18 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services14 patients

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.

14 services14 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 2

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

HATTIESBURG CLINIC, PA

Family Medicine

7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402

Lamar County (601) 261-1500

MRS. MISTY WALKER CAGLE FNP-C

Nurse Practitioner

7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402

Lamar County (601) 475-8270

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.

Which organizations bill Medicare for Crystal Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Wallace reassigns Medicare benefits to 2 organizations: Hattiesburg Clinic PA (Hattiesburg, MS) and Fast Pace Mississippi, PLLC (Ripley, MS). 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 Crystal Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Crystal Wallace accept?

Health plans from Cigna Healthcare, Molina Healthcare and UnitedHealthcare 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 16 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.