Kelly Wallace, NP
NPI 1417609694 · Nurse Practitioner · Petersburg, VA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kelly Wallace, NP is a Nurse Practitioner provider in Petersburg, VA (NPI 1417609694).
Provider details
- NPI number
- 1417609694
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 0024183547 (VA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
4 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
202 Medicare services, 2024 (ranked within specialty)
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 methodology.
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) |
|---|---|---|
| Emergency Department Visit With High Level of Medical Decision Making99285 | 128 | $142 |
| Emergency Department Visit With Moderate Level of Medical Decision Making99284 | 74 | $98 |
Typical Medicare-allowed amounts for these services range $98–$142 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote 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.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 5 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Naproxen | 23 | 20 |
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 12 | 12 |
| Albuterol Sulfatebrand: Albuterol Sulfate Hfa | 11 | — |
| Cephalexin | 11 | 11 |
| Ondansetronbrand: Ondansetron Odt | 11 | 11 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means , never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-01-19
- Last updated
- 2022-01-27
- Certified
- 2022-01-27
Frequently asked questions
- What is Kelly Wallace's NPI number?
- Kelly Wallace's National Provider Identifier (NPI) is 1417609694, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kelly Wallace's specialty?
- Kelly Wallace is listed in the NPPES registry with a primary specialty of Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kelly Wallace located?
- Kelly Wallace's practice location on file with NPPES is 200 Medical Park Blvd, Petersburg, VA 23805-9274.
- What is Kelly Wallace's phone number?
- The practice phone number listed in the NPPES registry for Kelly Wallace is (804) 765-5000.
- Does Kelly Wallace accept Medicare?
- Kelly Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kelly Wallace's NPI active?
- Yes — Kelly Wallace's NPI (1417609694) is active in the NPPES registry as of the last update on 2022-01-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.