Andrea Nicole Wallace, FNP - Medicare Nurse Practitioner in Charlotte, NC

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Andrea Nicole Wallace, FNP is a medicare enrolled "Nurse Practitioner - Family" in Charlotte, North Carolina. She graduated from nursing school in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Carolinas Physicians Network Inc., Eastland Urgent Care and her current practice location is 14214 Ballantyne Lake Rd, Ste 100, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 667-2650.

Andrea Nicole Wallace is licensed to practice in North Carolina (license number 5010264) 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 1417455809.

Contact Information

Andrea Nicole Wallace, FNP
14214 Ballantyne Lake Rd, Ste 100,
Charlotte, NC 28277-3372
(704) 667-2650
Not Available

Map and Direction




Provider's Profile

Full NameAndrea Nicole Wallace
GenderFemale
SpecialityNurse Practitioner
Experience9 Years
Location14214 Ballantyne Lake Rd, Charlotte, North Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Andrea Nicole Wallace graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1417455809
  • Provider Enumeration Date: 01/31/2018
  • Last Update Date: 07/15/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8729340849
  • Enrollment ID: I20180329000098

Medical Identifiers

Medical identifiers for Andrea Nicole Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417455809NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 5010264 (North Carolina)Secondary
363LF0000XNurse Practitioner - Family 5010264 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Carolinas Medical Center/behav HealthCharlotte, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Carolinas Physicians Network Inc.33754496552100
Eastland Urgent Care630585259117

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. Andrea Nicole Wallace allows following entities to bill medicare on her behalf.
Entity NameCarolinas Physicians Network Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437607686
PECOS PAC ID: 3375449655
Enrollment ID: O20040115000819
Entity NameEastland Urgent Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467481127
PECOS PAC ID: 6305852591
Enrollment ID: O20060224000538
Entity NameArboretum Urgent Care Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457380313
PECOS PAC ID: 8325059991
Enrollment ID: O20060510000344
Entity NameSteele Creek Urgent Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750317921
PECOS PAC ID: 9234130907
Enrollment ID: O20070123000481

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. Andrea Nicole 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 AddressPractice Location Address
Andrea Nicole Wallace, FNP
Po Box 19305,
Charlotte, NC 28219-9305

Ph: () -		Andrea Nicole Wallace, FNP
14214 Ballantyne Lake Rd, Ste 100,
Charlotte, NC 28277-3372

Ph: (704) 667-2650

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.