AMY D WALLIS (FNP) – Family Nurse Practitioner, NPI 1275598864

AMY D WALLIS (FNP) is a healthcare provider. based in Fort madison, Iowa. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 71002282A (IN). The NPI Number for AMY D WALLIS (FNP) is 1275598864

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
AMY D WALLIS (FNP)
NPI
1275598864
Phone
(319) 376-2134
Address
5409 AVENUE O
Enumeration Date
18 April 2006
Last Update Date
6 October 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3197681000
Graduation Year
2005 (21 years ago)
PAC ID
1052356490
Group Practice PAC ID
3870496417
Professional Enrollment ID
I20050625000013
Address ID
IA526551679WE1221XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

3,532 NURSE PRACTITIONER in IA

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Provider Addresses for AMY D WALLIS (FNP)

  • Fort Madison Community Hospital Physician & Professional Offices, 5409, Avenue O, Fort Madison, Lee, Iowa, 52627, United States

    FORT MADISON, IA 526279601

    Phone: (319) 376-2134

    Fax: (319) 376-2188

    Mailing address matches the actual address.

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: 2005-06-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050625000013INurse PractitionerIATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes583317$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit332332$0
99213Established patient office or other outpatient visit, 20-29 minutes198154$0
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit2828$0
G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment1414$0
View full utilization report →

Insurance plans in this area (ZIP 52627)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870496417View full group profile
NameSpecialtyState
P S Y C H I A T R YIA
P S Y C H I A T R YIA
Internal Medicine, Hospitalist, Internal MedicineIA
Certified Registered Nurse Anesthetist (Crna)IA
Nurse PractitionerIA
Family PracticeIA
Internal Medicine, Hospitalist, Internal MedicineTN
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
Rheumatology, Internal MedicineOH

Reviews

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Frequently asked questions

Can I verify AMY D WALLIS (FNP) with an NPI only?
You can start verification with NPI 1275598864 for AMY D WALLIS (FNP), then check state licensing separately.
Can I rely on AMY D WALLIS (FNP) being an active provider?
As of the registry snapshot, AMY D WALLIS (FNP) is marked active.
What is AMY D WALLIS (FNP) best known for clinically?
Directory data describes AMY D WALLIS (FNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is AMY D WALLIS (FNP) based?
AMY D WALLIS (FNP) is tied to Fort Madison, Iowa in the data we show; additional addresses may exist on the full record.
Why does AMY D WALLIS (FNP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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