Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sonny S Wallace, NP

Individual provider Nurse Practitioner · NPI 1164909339

Sonny S Wallace, NP is a Nurse Practitioner in Omaha, Nebraska. Graduated from University of Nebraska College of Medicine in 2018, 8 years ago. Practices with Iowa Physicians Clinic Medical Foundation, a 1,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Iowa and Nebraska.

Years since qualifying
8
Trained at
University of Nebraska College of Medicine
Licensed in
IA, NE
In the registry since
2018
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

7500 Mercy Rd
Omaha, NE 68124-2319
Phone: (855) 524-4001
Fax: (402) 398-5589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 112565 (NE)
Nurse Practitioner Taxonomy 363L00000X · Licence H152173 (IA)

Record details

NPI number1164909339
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 20, 2018
Last updated in NPPESSeptember 20, 2018
Mailing address7500 Mercy Rd, Omaha, NE 68124-2319

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Iowa Physicians Clinic Medical Foundation — 1242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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