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BRANDI WALLACE FNP
NPI 1982739900
Nurse Practitioner - Family in Fargo, ND

Active since February 22, 2007PECOS Enrolled
4622 40TH AVENUE SOUTH, SUITE A, FARGO, ND 58104(701) 364-2909 Get Directions Write a Review

NPPES record last updated: October 25, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 25, 2019, Mar 21, 2019, Nov 27, 2018 and 2 more (5 updates tracked since 2018).

About Brandi Wallace Fnp NPPES

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

BRANDI WALLACE FNP (NPI 1982739900) is an individual family provider in Fargo, North Dakota, licensed in North Dakota (R30131) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1982739900
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBRANDI WALLACECredential: FNP
Location Address4622 40TH AVENUE SOUTH, SUITE AFargo, ND 58104-4394
Mailing Address4500 36th Ave S Ste 100Fargo, ND 58104-5275 · (701) 361-2286
Phone(701) 364-2909
Sole ProprietorYes
Enumeration DateFebruary 22, 2007
Last NPPES UpdateOctober 25, 20195 updates tracked since enumeration
✔ NPI 1982739900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in ND · R30131
Also ListedRegistered NurseTaxonomy 163W00000X · License R144003-8 (MN), 149297-030 (WI)
4622 40TH AVENUE SOUTH, Fargo, ND 58104
Open in Google Maps ↗

Secondary Practice Locations 4

Location 12800 Cleveland Ave NRoseville, MN 55113-1126 · Phone (651) 642-1825
Location 24794 50th Ave SFargo, ND 58104-6027 · Phone (701) 361-2286
Location 34141 31st Ave S Ste 102Fargo, ND 58104 · Phone (701) 356-0097 · Fax (701) 356-0061
Location 44500 36th Ave S Ste 100Fargo, ND 58104-5275 · Phone (701) 361-2286

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brandi Wallace Fnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58104 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
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
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.

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 Brandi Wallace's NPI number?

The NPI number for Brandi Wallace is 1982739900. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

Where is Brandi Wallace located?

Brandi Wallace practices at 4622 40th Avenue South Suite A, Fargo, ND 58104. The listed phone number is (701) 364-2909.

What is Brandi Wallace's specialty?

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

Is Brandi Wallace enrolled in Medicare?

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

What insurance does Brandi Wallace accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Brandi 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 Brandi Wallace was last updated on October 25, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.