Shereece Nichole Wallace, DNP, AGPCNP-BC in Belleville, IL

Shereece Nichole Wallace, DNP, AGPCNP-BC is a medicare enrolled "Nurse Practitioner" in Belleville, Illinois. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southeastern Physician Services Pc and her current practice location is 4500 Memorial Dr, Belleville, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 257-6220.

Shereece Nichole Wallace is licensed to practice in Illinois (license number 209017027) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104338318.

Contact Information

	Shereece Nichole Wallace, DNP, AGPCNP-BC
	4500 Memorial Dr, Belleville, IL 62226-5360
	(618) 257-6220
	(618) 257-6679

Map and Direction

Provider's Profile

Full Name	Shereece Nichole Wallace
Gender	Female
Speciality	Nurse Practitioner
Experience	7 Years
Location	4500 Memorial Dr, Belleville, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shereece Nichole Wallace graduated from nursing school in 2017

NPI Data:

NPI Number: 1104338318
Provider Enumeration Date: 10/27/2017
Last Update Date: 03/28/2024

Medicare PECOS Information:

PECOS PAC ID: 1557627049
Enrollment ID: I20171116001820

Medical Identifiers

Medical identifiers for Shereece Nichole Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104338318	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	2017038282 (Missouri)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	209017027 (Illinois)	Secondary
363L00000X	Nurse Practitioner	209017027 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Christian Hospital Northeast	Saint louis, MO	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southeastern Physician Services Pc	0042307852	473

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shereece Nichole Wallace allows following entities to bill medicare on her behalf.

Entity Name	Physician Groups Lc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285664268 PECOS PAC ID: 3072421254 Enrollment ID: O20040220001157

Entity Name	Southeastern Physician Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083835441 PECOS PAC ID: 0042307852 Enrollment ID: O20160809000235

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shereece Nichole Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shereece Nichole Wallace, DNP, AGPCNP-BC 660 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8512 Ph: (314) 448-3791	Shereece Nichole Wallace, DNP, AGPCNP-BC 4500 Memorial Dr, Belleville, IL 62226-5360 Ph: (618) 257-6220

Reviews and Comments

Nurse Practitioner Nurses in Belleville, IL

Kelsey Beasley, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3060 Harvest Meadow Dr, Belleville, IL 62221 Phone: 618-792-8887
Ms. Lauren Nicole Marshall, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-5455 Fax: 618-257-4490
Mr. Lito T Rufin, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-6220
Cindy L. Auld, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Ste. 400, Belleville, IL 62226 Phone: 618-234-2390 Fax: 618-234-9936
Pamela A O'neal, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 130 Lincoln Place Ct, Belleville, IL 62221 Phone: 618-257-2029 Fax: 618-235-5371
Mrs. Deanna L. Rodenberg, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4550 Memorial Dr, Ste. 340, Belleville, IL 62226 Phone: 618-257-6200 Fax: 618-257-6679
Katherine Ann Combs, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4700 Memorial Dr Ste 250, Belleville, IL 62226 Phone: 618-212-6560

Shereece Nichole Wallace, DNP, AGPCNP-BC - Medicare Nurse Practitioner in Belleville, IL