PEGGY LYNN WALLACE (ARNP) – Adult Health Nurse Practitioner, NPI 1285930123
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for PEGGY LYNN WALLACE (ARNP)
110 W NORTH ST
TAMPA, FL 336046015
Phone: (813) 857-2679
Type: Mailing
4600 N HABANA AVE
SUITE 15
TAMPA, FL 336147112
Phone: (813) 870-4460
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 183 Open Payments records for all available years, with a total value of $6,326.
Total Amount is formed as General ($5,042) + Research ($1,285) + Ownership ($0) = $6,326.
Last reported payment date: 2024-12-27 • Largest payer in this snapshot: ViiV Healthcare Company ($2,074).
Total Amount
$6,326
General + Research + Ownership
Payments
183
Total payment records
General Amount
$5,042
General payments
Research Amount
$1,285
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $2,074 |
| ABBVIE INC. | $1,285 |
| Gilead Sciences, Inc. | $1,261 |
| Theratechnologies Inc. | $665 |
| Merck Sharp & Dohme LLC | $498 |
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: 2011-06-17
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20110617000280 | I | Nurse Practitioner | FL | 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 33604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Pediatric Medicine, Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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