Robert Wallace, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

53447 Issued in TN

Practice address

367 Hospital Blvd
Jackson, TN 38305-2080

Phone

(731) 661-2227

NPI assigned

Feb 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.wallacecrna.p20@direct.avp.nextgenshare.com

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.

• Barnet Dulaney Perkins Eye Center II PLLC

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1205305620
  NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1043910078
  NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1376574707
  NPD
• Gateway Anesthesia and Pain Associates PLLC

  • Pain Medicine Physician
  • Mesa, AZ
  • NPI 1710026125

  Anesthesiology

  NPD
• Summit Anesthesia Services PLLC

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
  • NPI 1821589144

  Anesthesiology

  NPD
• Jackson Anesthesia & Perioperative Consultants P C

  • Anesthesiology Physician
  • Jackson, TN
  • NPI 1669675807
  NPD (past)
• Professional Anesthesia Associates

  • Anesthesiology Physician
  • Jackson, TN
  • NPI 1568571743
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1003950288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 HOSPITAL BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052080",
            "telephone_number": "731-661-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 HOSPITAL BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052080",
            "telephone_number": "731-661-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "53447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla Walker, DOCTOR OF PHARMACY
• Traci Walker, APRN
• Tracie A Walker, MD
• Tracy Walker
• Kellie L Wallace-Wilding, MD
• Taurus Waller, MS
• Donna J Wallis, W.H.N.P.
• Morgan Walls, PHYSICAL THERAPY
• Rose Marie Walters, FNP
• Dong Wang, M.D.

• Certified Registered Nurse Anesthetist in Jackson, TN
• Providers in Jackson, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.