ANNA WALLACE (APRN) – Family Medicine Physician, NPI 1033982780
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for ANNA WALLACE (APRN)
3101 CHURCHILL DR STE 100
FLOWER MOUND, TX 750222717
Phone: (682) 237-7600
Fax: (817) 337-6866
Type: Mailing
4545 Heritage Trace Pkwy Ste 1500
Fort Worth, TX 762448938
Phone: (682) 683-2300
Type: Location
1720 Fm 544 Ste 100
Lewisville, TX 750564592
Phone: (682) 683-2301
Type: Location
4150 N Collins St
Arlington, TX 760054547
Phone: (682) 683-2301
Type: Location
9990 Dallas Pkwy Ste 125
Frisco, TX 750334137
Phone: (682) 683-2301
Type: Location
7230 Crawford Rd
Argyle, TX 762262677
Phone: (682) 683-2300
Type: Location
208 N Highway 377
Roanoke, TX 762626170
Phone: (682) 237-7600
Type: Location
1725 Chadwick Ct Ste 100
Hurst, TX 760543351
Phone: (817) 281-4446
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $122.
Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Dexcom, Inc. ($122).
Total Amount
$122
General + Research + Ownership
Payments
1
Total payment records
General Amount
$122
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $122 |
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: 2024-04-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240429001421 | I | Nurse Practitioner | TX | 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 75022)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX |
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