JAILENE WALLACE FNP-C
NPI 1891678702
Nurse Practitioner - Family in Providence, RI
About Jailene Wallace Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAILENE WALLACE FNP-C (NPI 1891678702) is an individual family provider in Providence, Rhode Island, licensed in Rhode Island (APRN04646) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
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
Jailene 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02907 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jailene Wallace's NPI number?
The NPI number for Jailene Wallace is 1891678702. It was assigned to this individual provider in the NPPES registry on July 29, 2025.
Where is Jailene Wallace located?
Jailene Wallace practices at 712 Broad St, Providence, RI 02907. The listed phone number is (401) 233-5060.
What is Jailene Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jailene Wallace enrolled in Medicare?
Yes. Jailene 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.
When was this NPI record last updated?
The NPPES record for Jailene Wallace was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Jailene Wallace, FNP-C · NPI 1891678702
Family physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since July 29, 2025.
## Identity
- **NPI:** 1891678702 (Entity type: Individual)
- **Enumerated:** July 29, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** APRN04646 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 712 BROAD ST, Providence, RI 02907-1465
- **Phone:** (401) 233-5060
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** September 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1891678702) · Data from the CMS NPPES public registry.