Lisa S Vanderwall, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APN16963 Issued in TN

Practice address

975 E. Third Street
Chattanooga, TN 37403-2147

Phone

(423) 778-7608

Fax

(423) 778-2360

NPI assigned

Aug 15, 2012

Last updated

Nov 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watson Anesthesia Group PLLCGroup PAC ID 8123270154, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhea Medical Center Hospital, Dayton, TN, CCN 441310

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Watson Anesthesia Group PLLC

  • Certified Registered Nurse Anesthetist
  • Dayton, TN
  • NPI 1548513278

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Rhea Medical Center

  • Hospitalist Physician
  • Dayton, TN
  • NPI 1972211803
  NPD

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

• Rhea Medical Center

  • Critical Access Hospital
  • Dayton, TN
  • NPI 1811987084
  Care Compare affiliation

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1194073650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012225",
            "telephone_number": "423-892-5602",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E. THIRD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7608",
            "fax_number": "423-778-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWALL",
        "first_name": "LISA",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN16963",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN161224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond William Vancleaf, RN
• Sharon Vancleave, SLP/CCC
• Douglas L Vanderbilt, MD
• Cynthia Dana Vandergriff
• Miranda Danielle Vandergriff, LPN
• Victoria Lauren Vanderwall, RN
• Vanessa Moyes DDS (Dentistry of Chattanooga PLLC)
• Adam John Vanmason, M.D.
• Traci Vannostran, M.S., CCC-SLP
• Harsha Gadadhar Vardhana, M.D.

• Certified Registered Nurse Anesthetist in Chattanooga, TN
• Providers in Chattanooga, 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 1, 2012; 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.