Stephanie Louise Wallace

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R160036 Issued in MD

Practice address

6701 N Charles St Ste 4226
Towson, MD 21204-6808

Phone

(410) 296-4616

Fax

(410) 337-5068

NPI assigned

Feb 5, 2010

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

GBMC Hospital Based Services LLCGroup PAC ID 6002299369, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swallace1084008@direct.hopkinsmedicine.org

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.

• GBMC Hospital Based Services, LLC.

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1730824400
  Medicare reassignment Care Compare group NPD
• Anesthesia Company, LLC

  • Anesthesiology Physician
  • Annapolis, MD
  • NPI 1871548156

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• First Colonies Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Columbia, MD
  • NPI 1740218767

  DC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  Medicare reassignment NPD
• Lifebridge Community Gastroenterology, LLC

  • Gastroenterology Physician
  • Pikesville, MD
  • NPI 1033558416
  Medicare reassignment NPD
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879
  Medicare reassignment NPD
• North Calvert Anesthesiology Services LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1710360227
  Medicare reassignment NPD
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD
• Johns Hopkins University

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1386631810
  NPD
• Pikesville MD Endoscopy ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Baltimore, MD
  • NPI 1043497019
  NPD
• Dr Wendy Kloesz, M.D., P.a

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1144472887
  NPD (past)

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

• Greater Baltimore Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1255372397
  Care Compare affiliation

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1518299197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 KENILWORTH DR STE 317",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212042146",
            "telephone_number": "410-296-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST STE 4226",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-296-4616",
            "fax_number": "410-337-5068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 N. Calvert Street",
            "address_2": "Department of Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022102",
            "country_code": "US",
            "telephone_number": "410-332-9375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "STEPHANIE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R160036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570079500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natoya Walker
• Debora Lynn Wall, PTA
• Stacy Wall
• Ellen Wallace
• Shawnelle Wallace
• Ashley Waller, LGPC
• Morolayo Olajumoke Waller, CNM
• Philip Douglas Walls, M.D.
• Walter B Koppel PC
• Walter R. Welzant MD PA

• Certified Registered Nurse Anesthetist in Towson, MD
• Providers in Towson, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.