Hailey D Wallace, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CRNA.019718 Issued in OH

Practice address

930 Bethel Rd
Columbus, OH 43214-1906

Phone

(614) 451-0500

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Hailey D Jones Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Premier Anesthesiologists, LTD.

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1154473494
  Medicare reassignment NPD
• Consultant Anesthesiologists Inc

  • Specialist
  • Westerville, OH
  • NPI 1457420580
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1104305432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CROSS POINTE RD STE C",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306692",
            "telephone_number": "614-761-1255",
            "fax_number": "614-552-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141906",
            "telephone_number": "614-451-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "HAILEY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "CRNA.019718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAILEY",
            "last_name": "JONES",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connie L. Wallace, LPCC-S
• Crisha Marie Wallace, CDCA
• Daiveah Wallace
• Deanna Marie Wallace
• Elizabeth Ann Wallace, DC
• Janet Ann Wallace, CNP
• Jastyn Wallace, MSW, LISW
• Kelly Dugan Wallace
• Margot Wallace, RN, LSN
• Molly Wallace

• Certified Registered Nurse Anesthetist in Columbus, OH
• Providers in Columbus, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.