JELISA WALLACE CRNP
NPI 1649889478
Nurse Practitioner - Family in Huntsville, AL

Q: What is Jelisa Wallace's NPI number?

The NPI number for Jelisa Wallace is 1649889478. It was assigned to this individual provider in the NPPES registry on July 28, 2020.

Q: What is Jelisa Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jelisa Wallace was last updated on March 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 28, 2020PECOS Enrolled

101 SIVLEY RD SW, HUNTSVILLE, AL 35801(256) 265-1000 Get Directions Write a Review

NPPES record last updated: March 12, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Jelisa Wallace Crnp NPPES

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

JELISA WALLACE CRNP (NPI 1649889478) is an individual family provider in Huntsville, Alabama, licensed in Alabama (F06200386) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649889478

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJELISA WALLACECredential: CRNP

Location Address101 SIVLEY RD SWHuntsville, AL 35801-4421

Mailing Address2306 Cumberland Ave SwDecatur, AL 35603-2611 · (256) 466-5717

Phone(256) 265-1000

Sole ProprietorNo

Enumeration DateJuly 28, 2020

Last NPPES UpdateMarch 12, 2024

NPPES CertifiedMarch 12, 2024

✔ NPI 1649889478 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 AL · F06200386

101 SIVLEY RD SW, Huntsville, AL 35801

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jelisa Wallace Crnp 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.

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.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

302 services75 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

98 services94 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35801 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

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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 20

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

DR. STEVEN CLAY OSBORNE JR. M.D.

Anesthesiology