LAURA ANN WALLACE (A.P.N) – Family Nurse Practitioner, NPI 1265737753

LAURA ANN WALLACE (A.P.N) is a healthcare provider. based in Dyersburg, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials A.P.N. They hold a License No. 2010037004 (MO). The NPI Number for LAURA ANN WALLACE (A.P.N) is 1265737753

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
LAURA ANN WALLACE (A.P.N)
NPI
1265737753
Phone
(731) 286-1900
Address
1445 US HIGHWAY 51 BYP E
Enumeration Date
14 January 2011
Last Update Date
7 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5735460184
Graduation Year
2010 (16 years ago)
PAC ID
7416134036
Group Practice PAC ID
0941207526
Professional Enrollment ID
I20260406001419
Address ID
MO636637862PI301XX21XX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for LAURA ANN WALLACE (A.P.N)

  • 1445 US HIGHWAY 51 BYP E

    DYERSBURG, TN 380242127

    Phone: (731) 286-1900

    Fax: (731) 286-1939

    Type: Mailing

  • 301 N HIGHWAY 21

    PILOT KNOB, MO 636637862

    Phone: (573) 546-8036

    Fax: (573) 546-8067

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $390.

Total Amount is formed as General ($390) + Research ($0) + Ownership ($0) = $390.

Last reported payment date: 2024-11-28 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($77).

Total Amount

$390

General + Research + Ownership

Payments

20

Total payment records

General Amount

$390

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-28

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-08-02

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
I20110802000333INurse PractitionerTNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38024)

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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: 0941207526View full group profile
NameSpecialtyState
Nurse PractitionerMO
Physician AssistantMO
Cardiovascular Disease (Cardiology), Internal MedicineMO
Internal Medicine, Pulmonary Disease, Critical Care (Intensivists)MO
Osteopathic Manipulative MedicineMO
-MO
General SurgeryMO
Nurse PractitionerMO
Diagnostic RadiologyMS
Nurse PractitionerMO

Reviews

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Frequently asked questions

Is there an official ID for LAURA ANN WALLACE (A.P.N) in U.S. healthcare records?
The official identifier for LAURA ANN WALLACE (A.P.N) is NPI 1265737753.
Is LAURA ANN WALLACE (A.P.N) still an active registrant?
LAURA ANN WALLACE (A.P.N) carries an active NPI according to the public dataset.
What area of care is associated with LAURA ANN WALLACE (A.P.N)?
LAURA ANN WALLACE (A.P.N)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LAURA ANN WALLACE (A.P.N)?
Travel planning: use Dyersburg, Tennessee as the reference point for LAURA ANN WALLACE (A.P.N), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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