STEPHANIE R WALLACE (NP) – Nurse Practitioner, NPI 1124087879
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for STEPHANIE R WALLACE (NP)
1199 Prince Ave
Athens, GA 306062797
Phone: (706) 475-5076
Type: Location
1230 BAXTER ST
ATHENS, GA 306063712
Phone: (706) 389-2273
Fax: (706) 389-2298
Type: Location
PO BOX 48089
ATHENS, GA 306048089
Phone: (706) 389-3740
Fax: (706) 389-3951
Type: Mailing
Paces Ferry Road Northwest, Atlanta, Fulton County, Georgia, 30327, United States
SUITE 1-1100 (ATTENTION DENISE)
ATLANTA, GA 30339
Phone: (470) 271-3412
Type: Mailing
Clifton Road Northeast, Emory Highlands, Druid Hills, DeKalb County, Georgia, 30329, United States
BUILDING A 4TH FLOOR
ATLANTA, GA 303221013
Phone: (404) 778-5413
Fax: (404) 778-3527
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $295.
Total Amount is formed as General ($295) + Research ($0) + Ownership ($0) = $295.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Boston Scientific Corporation ($295).
Total Amount
$295
General + Research + Ownership
Payments
4
Total payment records
General Amount
$295
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $295 |
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: 2005-08-31
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 |
|---|---|---|---|---|
| I20050831000942 | I | Nurse Practitioner | GA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 71 | 51 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 44 | 44 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 43 | 43 | $0 |
| 99497 | Advance care planning, first 30 minutes | 36 | 32 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 26 | 22 | $0 |
Insurance plans in this area (ZIP 30606)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | NC | |
| - | GA | |
| Cardiovascular Disease (Cardiology) | GA | |
| - | GA | |
| Internal Medicine | GA | |
| - | GA | |
| N E U R O S U R G E R Y | GA | |
| - | GA |
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