AMANDA GAIL WALLACE – Family Nurse Practitioner, NPI 1154844041
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for AMANDA GAIL WALLACE
PO BOX 550
VANCEBURG, KY 411790550
Phone: (606) 796-3029
Type: Mailing
6460 HARRISON AVE STE 200
CINCINNATI, OH 452477958
Phone: (513) 941-4999
Fax: (513) 694-0168
Type: Mailing
142, Depot Drive, South Shore, Greenup County, Kentucky, 41175, United States
SOUTH SHORE, KY 411759306
Phone: (606) 932-2271
Type: Location
247 CIC BLVD
WEST UNION, OH 456937512
Phone: (513) 941-4999
Fax: (513) 694-0168
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 32 Open Payments records for all available years, with a total value of $526.
Total Amount is formed as General ($526) + Research ($0) + Ownership ($0) = $526.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Novo Nordisk Inc ($96).
Total Amount
$526
General + Research + Ownership
Payments
32
Total payment records
General Amount
$526
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $96 |
| Lilly USA, LLC | $48 |
| Ferring Pharmaceuticals Inc. | $48 |
| SANOFI-AVENTIS U.S. LLC | $46 |
| AstraZeneca Pharmaceuticals LP | $43 |
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: 2023-07-12
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 |
|---|---|---|---|---|
| I20170920003460 | I | Nurse Practitioner | KY | TBD |
| I20230712000375 | I | Nurse Practitioner | OH | 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 41179)
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