Doctor profile · Federal record
Dr. Kelly Wallace, NP
Nurse Practitioner · Petersburg, VA
- NPI 1417609694
- Accepts Medicare
- 5 yrs in practice
- Female
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
200 Medical Park Blvd
Petersburg, VA 238059274
(804) 765-5000 - Mailing address
-
2610 Setting Sun Dr
Powhatan, VA 231397552
Credentials & registration
- NPI registered
- January 2022 — 4 yrs on file
- Profile last updated
- January 27, 2022
- Year of graduation
- 2021 — 5 yrs since
- Specialty taxonomy
- 363L00000X — NUCC code
- State license (1)
- Virginia #0024183547
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1417609694. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
165
Distinct HCPCS
3
Medicare allowed
$18,096
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99284 |
Emergency department visit with moderate level of medical decision making | 93 | 91 | $100 | |
99285 |
Emergency department visit with high level of medical decision making | 54 | 53 | $143 | |
99283 |
Emergency department visit with low level of medical decision making | 18 | 18 | $60 |
In context: peer comparison
Among 4 peers in this city , average services per provider: 40. This provider delivers 4.1× the peer median.Medicare Part D · 2023
Top prescriptions
Total claims
48
Patients
46
Total drug cost
$261
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Naproxen | Generic | 34 | 32 | $164 |
| Cephalexin | Generic | 14 | 14 | $97 |
Hospital affiliations
Frequently asked questions
What is Dr. Kelly Wallace's medical specialty?
Dr. Kelly Wallace practices Nurse Practitioner in Petersburg, VA.
Where does Dr. Kelly Wallace practice?
Dr. Kelly Wallace practices at 200 Medical Park Blvd, Petersburg, VA 238059274. Office phone: 8047655000.
What is Dr. Kelly Wallace's NPI?
Dr. Kelly Wallace's National Provider Identifier (NPI) is 1417609694, issued by NPPES.
Does Dr. Kelly Wallace accept Medicare assignment?
Yes. Dr. Kelly Wallace accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Kelly Wallace commonly perform?
Top Medicare-reported procedures in 2023: Emergency department visit with moderate level of medical decision making (HCPCS 99284); Emergency department visit with high level of medical decision making (HCPCS 99285); Emergency department visit with low level of medical decision making (HCPCS 99283). Source: CMS Medicare Physician & Other Practitioners file.