ALEXANDRIA WALLACE – Family Nurse Practitioner, NPI 1811468135
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,682 NURSE PRACTITIONER in AL
Provider Addresses for ALEXANDRIA WALLACE
802 Bank St NE
Decatur, AL 356011612
Phone: (205) 977-9876
Fax: (205) 977-9976
Type: Location
Maree Drive, Athens, Limestone County, Alabama, 35613, United States
ATHENS, AL 356135870
Phone:
Type: Mailing
Whitesport Circle Southwest, Piedmont, Huntsville, Madison County, Alabama, 358, United States
HUNTSVILLE, AL 358017420
Phone: (256) 874-4122
Type: Location
101 SIVLEY RD SW
HUNTSVILLE, AL 358014421
Phone: (256) 265-6603
Type: Mailing
707 W MARKET ST STE C
ATHENS, AL 356112463
Phone: (256) 444-1815
Fax: (256) 444-0385
Type: Mailing
4810 WHITESPORT CIR SW STE 110
HUNTSVILLE, AL 358017439
Phone: (205) 977-9876
Fax: (205) 977-9976
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-03-11
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190311001065 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | AL |
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