MRS. JOANNE WALLIS (ANP) – Family Nurse Practitioner, NPI 1265437172

MRS. JOANNE WALLIS (ANP) is a healthcare provider. based in Warm springs, Oregon. specializing in Family Nurse Practitioner. They hold the professional credentials ANP. They hold a License No. 389 (AK). The NPI Number for MRS. JOANNE WALLIS (ANP) is 1265437172

Main info

Female
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JOANNE WALLIS (ANP)
NPI
1265437172
Phone
(541) 553-1196
Address
1270 KOT-NUM ROAD
Enumeration Date
16 June 2005
Last Update Date
2 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9074516682
Graduation Year
2003 (23 years ago)
PAC ID
1153455381
Group Practice PAC ID
9537050109
Professional Enrollment ID
I20100810000660
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

Provider Addresses for MRS. JOANNE WALLIS (ANP)

  • 1270 KOT-NUM ROAD

    WARM SPRINGS, OR 977611209

    Phone: (541) 553-1196

    Fax: (541) 553-2135

    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: 2010-08-10

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100810000660INurse PractitionerTXTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes1817$0
99214Established patient office or other outpatient visit, 30-39 minutes1312$0
View full utilization report →

Insurance plans in this area (ZIP 97761)

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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: 9537050109View full group profile
NameSpecialtyState
-AZ
Nurse PractitionerAK
-TX
Physician AssistantTX
-AK
-ME
Nurse PractitionerGA
Family Practice, Addiction Medicine, Osteopathic Manipulative MedicineAK
Physician AssistantAK
-NY

Reviews

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Frequently asked questions

What is the registry number for MRS. JOANNE WALLIS (ANP)?
The registry entry for MRS. JOANNE WALLIS (ANP) shows NPI 1265437172.
Does the public listing show MRS. JOANNE WALLIS (ANP) as active?
MRS. JOANNE WALLIS (ANP)'s NPI record reflects an active status in NPPES.
How should patients interpret MRS. JOANNE WALLIS (ANP)'s specialty?
The extract shows Family Nurse Practitioner for MRS. JOANNE WALLIS (ANP). Clinical services aligned with this taxonomy classification.
What city is tied to MRS. JOANNE WALLIS (ANP)?
The directory associates MRS. JOANNE WALLIS (ANP) with Warm Springs, Oregon. Check all listed addresses for suites or satellite offices.
Why is information missing for MRS. JOANNE WALLIS (ANP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.