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Active NPI 1932989357 Individual Practitioner Female Practitioner

Marysa P Wallace , AGNP-C

Nurse Practitioner • Fayetteville, GA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Marysa Wallace, AGNP-C is a certified Nurse Practitioner practicing in Fayetteville, GA. With approximately 10 years of clinical experience since graduating from Mercer University School Of Medicine in 2016, Marysa Wallace delivers high-quality medical care to the local community at 132 OLD NORTON RD STE 200.

Marysa Wallace is affiliated with Nsh Cancer Institute Professional Services G Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

132 Old Norton Rd Ste 200

Fayetteville, GA 302154873

Telephone 6788171117
Fax 6788170823
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Mercer University School Of Medicine

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Fayetteville, GA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
10 Yrs +0.6 yrs vs City Avg
City Avg: 9.4 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
48 Specialists

Practicing in Fayetteville, GA (3149 Statewide)

Telehealth Adoption Rate
10.4% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
73.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (10 Years) 10 Yrs
Fayetteville Specialty Average (9.4 Years) 9.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
174 113 $213.00 $57.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
19 15 $314.00 $85.09
99442 Telephone medical discussion with physician, 11-20 minutes
18 15 $228.00 $54.61

Medical Specialties & State Licenses

CMS Verified: 2024-08-14
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License GA RN259981

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Nsh Cancer Institute Professional Services G Llc

132 Old Norton Rd, Fayetteville, GA 302154873

Phone: 6788171117

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Donna Hendley , PA-C

Physician Assistant

NPI 1093885873

Physician Assistant (Certified)

Dr. Shyam Khanwani , MD

Internal Medicine - Hematology & Oncology

NPI 1184602856

Doctor of Medicine (M.D.)

Jessica Mathis , FNP-C

Nurse Practitioner

NPI 1235511338

Family Nurse Practitioner (Certified)

Clavel Gittens , FNP-BC

Nurse Practitioner - Family

NPI 1396813986

Family Nurse Practitioner (Board Certified)

Dr. Kim Phuong Nguyen , PharmD

Pharmacist - Oncology

NPI 1487102174

Doctor of Pharmacy (Pharm.D.)

Dr. Daniel Carr , MD

Internal Medicine - Hematology & Oncology

NPI 1497733992

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address August 14, 2024

Registered at 1835 SAVOY DR STE 203, ATLANTA, GA 303411073 (Tel: 7704969430)

NPI Profile Active October 03, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location October 03, 2023

Registered at 132 OLD NORTON RD STE 200, FAYETTEVILLE, GA 302154873 (Tel: 6788171117)

📍
Updated Business Mailing Address October 03, 2023

Registered at 1835 SAVOY DR STE 300, ATLANTA, GA 303411071 (Tel: 7704969430)

👤
Provider Name / Credentials Updated October 03, 2023

Recorded as MARYSA WALLACE, AGNP-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2023

Nurse Practitioner (License #RN259981 in GA)

🟢
Initial NPI Registration & Enumeration October 03, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1932989357
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2023
Last Update: August 14, 2024
Sole Proprietor: No

Mailing Address

1835 Savoy Dr Ste 203

Atlanta, GA 303411073

Phone: 7704969430

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.