Active NPI
Jacqueline C Qualles, CRNA
- Certified Registered Nurse Anesthetist
- Durham, NC
National Provider Identifier
1407990468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 343495
- Practice address
- 1104 Red Oak Ave
Durham, NC 27707-4924 - Phone
- (919) 806-9202
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 343495L | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | 343495 | PA | Primary |
Addresses
Primary practice location
1104 Red Oak Ave
Durham, NC 27707-4924
Mailing address
1104 Red Oak Ave
Durham, NC 27707-4924
Phone (919) 806-9202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 343495L | PA | MD | Registered Nurse |
| 343495 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lenoir Memorial Hospital, Incorporated | Past | Accepting new patients | |
| Lenoir Memorial Hospital, Incorporated | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Orange Anesthesia Services P.C.. | Past | Accepting new patients | |
| Pittsburgh Anesthesia Associates, LTD. | Past | Accepting new patients | |
| Chambersburg Anesthesia Associates | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Cardiology Technician
- Kinston, NC
- NPI 1013957414
-
- Certified Registered Nurse Anesthetist
- Kinston, NC
- NPI 1679517296
Nurse Anesthetist, Certified Registered
-
- Pain Medicine (Anesthesiology) Physician
- Chambersburg, PA
- NPI 1992798516
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Middletown, NY
- NPI 1760434690
-
- Anesthesiology Physician
- Pittsburgh, PA
- NPI 1093701484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1407990468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 RED OAK AVE",
"city": "DURHAM",
"state": "NC",
"postal_code": "277074924",
"telephone_number": "919-806-9202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 RED OAK AVE",
"city": "DURHAM",
"state": "NC",
"postal_code": "277074924",
"telephone_number": "919-806-9202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUALLES",
"first_name": "JACQUELINE",
"middle_name": "C",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "343495L",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "343495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.