Individual provider Active NPI

Joyce Wallace, CRNA, ARNP

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1003246257
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9309567 Issued in FL
Practice address
2165 Herschel St
Jacksonville, FL 32204-3819
Phone
(904) 387-4030
NPI assigned
Nov 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9309567 FL
Certified Registered Nurse Anesthetist 367500000X 9309567 FL Primary

Addresses

Primary practice location

2165 Herschel St
Jacksonville, FL 32204-3819

Mailing address

916 Alameda LN
Saint Johns, FL 32259-6903
Phone (419) 512-3374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140211000646 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557590742 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jax Anesthesia Providers LLCGroup PAC ID 5698783702, 31 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (954) 939-5000

1670 St Vincents Way
Middleburg, FL 32068-8447
Phone (954) 939-5000

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 483-5850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9309567FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 3, 2016 Accepting new patients
Jax Anesthesia Providers LLC CurrentSince Sep 1, 2016 Accepting new patients
North Florida Anesthesia Consultants Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2014 Accepting new patients
North Florida Anesthesia Consultants, Inc. CurrentSince Feb 3, 2014 Accepting new patients
Quiescence Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 6, 2024 Accepting new patients
Anesthesia Consultants PA CurrentSince Jun 29, 2016 Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

5191 First Coast Tech Pkwy
Fl 1
Jacksonville, FL 32224
Phone (904) 593-5146

9726 Touchton Rd
Ste 305
Jacksonville, FL 32246
Phone (904) 686-6020

7051 Southpoint Pkwy S
Jacksonville, FL 32216
Phone (904) 432-1521

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

1780 N Mills Ave
Orlando, FL 32803
Phone (407) 426-8484

1879 Nightingale Ln
Ste A1
Tavares, FL 32778
Phone (352) 401-1919

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1003246257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 ALAMEDA LN",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322596903",
            "telephone_number": "419-512-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043819",
            "telephone_number": "904-387-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOYCE",
        "credential": "CRNA, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-24",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9309567",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9309567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.