Gregory Scott Wallis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

630401 Issued in TX

Practice address

1204 N Mound St
Nacogdoches, TX 75961-4027

Phone

(936) 568-8444

NPI assigned

Jan 23, 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

Enrolled in TX

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

76.9 of 100Reported as group

Quality

72.83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Emergenchealth PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1467970897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Grasshopper Anesthesia Services PLLC

  • Certified Registered Nurse Anesthetist
  • Nacogdoches, TX
  • NPI 1932635752

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Texas Anesthesia Partners

  • Certified Registered Nurse Anesthetist
  • Nacogdoches, TX
  • NPI 1184656001

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Texas Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Southlake, TX
  • NPI 1144673468
  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  Nurse Anesthetist, Certified Registered, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1376698290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 COUNTY ROAD 253",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759656980",
            "telephone_number": "936-554-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-568-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "630401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0163)
• Wal-Mart Stores Texas, LP (Vision Center 30-0163)
• Walgreen Co (Walgreens #09400)
• Latoya Walker, MA
• Dayna Wall
• Aisha Ligon Warfield, APRN
• Warthan Dermatology Center
• Warthan Dermatology Nacogdoches PLLC
• T Lynn Warthan, MD
• Melinda Watts, ATC

• Certified Registered Nurse Anesthetist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.