BETHANY WALLS – Family Nurse Practitioner, NPI 1063052231
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for BETHANY WALLS
901 MCCLINTOCK DR STE 202
BURR RIDGE, IL 605270872
Phone: (630) 655-6748
Type: Mailing
1200 W LOUCKS AVE
PEORIA, IL 616042604
Phone: (309) 306-7421
Type: Location
789 Old Nashville Hwy
Mc Ewen, TN 371014578
Phone: (309) 370-2564
Type: Location
789 OLD NASHVILLE HWY
MC EWEN, TN 371014578
Phone: (309) 370-2564
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $116.
Total Amount is formed as General ($116) + Research ($0) + Ownership ($0) = $116.
Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($116).
Total Amount
$116
General + Research + Ownership
Payments
1
Total payment records
General Amount
$116
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boehringer Ingelheim Pharmaceuticals, Inc. | $116 |
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: 2023-05-10
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 |
|---|---|---|---|---|
| I20230510002102 | I | Nurse Practitioner | IL | 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 |
|---|---|---|---|---|
| 96413 | Administration of chemotherapy into vein, 1 hour or less | 17 | 16 | $0 |
Insurance plans in this area (ZIP 60527)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Nurse Practitioner | MI | |
| - | IL | |
| Infectious Disease | IL | |
| Emergency Medicine, Family Practice | TN | |
| Physician Assistant | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Nurse Practitioner | FL | |
| Physician Assistant | IL |
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