Phyllis Wallace, APRN
NPI 1366486417 · Family Nurse Practitioner · Konawa, OK
Provider details
- NPI number
- 1366486417
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- R0035497 (OK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
20 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
271 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of a Standardized, Evidence-Based Social Determinants of Health Risk Assessment Tool, 5-15 MinutesG0136 | 91 | $0 |
| Blood Test, Comprehensive Group of Blood Chemicals80053 | 52 | $10 |
| Complete Blood Cell Count (red Cells, White Blood Cell, Platelets), Automated Test and Automated Differential White Blood Cell Count85025 | 45 | $7 |
| Hemoglobin A1c Level83036 | 30 | $10 |
| Blood Test, Lipids (cholesterol and Triglycerides)80061 | 28 | $13 |
| Automated Urinalysis Test81003 | 25 | $2 |
Typical Medicare-allowed amounts for these services range $0–$13 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$18 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-06-16
- Last updated
- 2021-11-22
- Certified
- 2021-11-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.