BRANDI WALLACE (FNP) – Family Nurse Practitioner, NPI 1982739900
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BRANDI WALLACE (FNP)
2800 Cleveland Ave N
Roseville, MN 551131126
Phone: (651) 642-1825
Type: Location
4794 50th Ave S
Fargo, ND 581046027
Phone: (701) 361-2286
Type: Location
4141 31st Ave S Ste 102
Fargo, ND 58104
Phone: (701) 356-0097
Fax: (701) 356-0061
Type: Location
4500 36th Ave S Ste 100
Fargo, ND 581045275
Phone: (701) 361-2286
Type: Location
4500 36TH AVE S STE 100
FARGO, ND 581045275
Phone: (701) 361-2286
Type: Mailing
4622 40TH AVENUE SOUTH
SUITE A
FARGO, ND 581044394
Phone: (701) 364-2909
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $669.
Total Amount is formed as General ($669) + Research ($0) + Ownership ($0) = $669.
Last reported payment date: 2024-02-08 • Largest payer in this snapshot: ABBVIE INC. ($637).
Total Amount
$669
General + Research + Ownership
Payments
8
Total payment records
General Amount
$669
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $637 |
| REVANCE THERAPEUTICS, INC. | $18 |
| Novo Nordisk Inc | $14 |
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: 2022-01-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190422002540 | I | Nurse Practitioner | ND | TBD |
| I20220111001663 | I | Nurse Practitioner | MN | 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 55113)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | ND | |
| Interventional Radiology | ND | |
| General Surgery | MN | |
| Nurse Practitioner | ND | |
| Physical Therapist In Private Practice | ND | |
| Nurse Practitioner | ND | |
| Hospitalist, Internal Medicine | ND | |
| Family Practice | ND | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | ND |
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