SHEREECE NICHOLE WALLACE (DNP, AGPCNP-BC) – Nurse Practitioner, NPI 1104338318
Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for SHEREECE NICHOLE WALLACE (DNP, AGPCNP-BC)
670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 631418573
Phone: (314) 953-8799
Fax: (314) 953-8798
Type: Mailing
4500 Memorial Dr
Belleville, IL 622265360
Phone: (618) 257-6220
Fax: (618) 257-6679
Type: Location
11133 Dunn Rd
Saint Louis, MO 631366163
Phone: (314) 653-5000
Type: Location
11155 Dunn Rd Ste 109N
Saint Louis, MO 631366148
Phone: (314) 953-8799
Type: Location
2122 Troy Rd Ste 130
Edwardsville, IL 620252540
Phone: (618) 800-4500
Type: Location
660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 631418512
Phone: (314) 448-3791
Fax: (636) 996-7658
Type: Mailing
1 MEMORIAL DR
ALTON, IL 620026722
Phone: (618) 463-7240
Type: Location
11155 DUNN RD STE 109N
SAINT LOUIS, MO 631366148
Phone: (314) 953-8799
Type: Mailing
Dunn Road, Riverview, Spanish Lake, Saint Louis County, Missouri, 63138, United States
SAINT LOUIS, MO 631366148
Phone: (314) 953-8799
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 $171.
Total Amount is formed as General ($171) + Research ($0) + Ownership ($0) = $171.
Last reported payment date: 2024-08-27 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($122).
Total Amount
$171
General + Research + Ownership
Payments
4
Total payment records
General Amount
$171
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $122 |
| Janssen Pharmaceuticals, Inc | $20 |
| EMD Serono, Inc. | $15 |
| ABBVIE INC. | $15 |
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: 2021-08-30
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 |
|---|---|---|---|---|
| I20171116001820 | I | Nurse Practitioner | MO | TBD |
| I20210830003376 | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 401 | 115 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 75 | 35 | $0 |
| 99238 | Hospital discharge day management, 30 minutes or less | 35 | 34 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 33 | 32 | $0 |
Insurance plans in this area (ZIP 63141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| G A S T R O E N T E R O L O G Y | GA | |
| Physician Assistant | IL | |
| - | MO | |
| Gastroenterology, Gastroenterology, Internal Medicine | OH |
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