AMY D WALLIS FNP NPI 1275598864

NPI Information

  • NPI: 1275598864
  • Provider Name: AMY D WALLIS, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5409 AVENUE O
    FORT MADISON, IA
    ZIP 52627
  • Phone: (319) 376-2134

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NPI Details

Amy D Wallis, FNP is a family nurse practitioner in Fort Madison, IA with 21 years of experience. Amy D Wallis, FNP NPI is 1275598864. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5409 AVENUE O
FORT MADISON, IA
ZIP 52627-601
Phone: (319) 376-2134
Fax: (319) 376-2188

The NPI 1275598864 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Follow-up nursing facility visit per day, typically 10 minutes (HCPCS:99307)
  • Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (HCPCS:G0438)
  • Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)
  • Transitional care management services for problem of moderate complexity (HCPCS:99495)

The enumeration date for this NPI number is 4/18/2006 and was last updated on 10/6/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily71002282AINDIANANo
2363LF0000XNurse PractitionerFamily100507IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11275598864MEDICAIDIOWA
2200848020AMEDICAIDINDIANA
3CG3197OTHERINDIANAMEDCARE RAILROAD GROUP
41275598864OTHERIOWAWELLMARK BLUE CROSS BLUE SHIELD
5511790018MEDICARE PINIOWA
6P00456554OTHERINDIANARAILROAD MEDICARE
7Q45624MEDICARE UPININDIANA
8941190A6MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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