Jon T Wall, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R866388 Issued in MS

Practice address

1220 Jefferson St
Laurel, MS 39440-4355

Phone

(601) 426-4000

Fax

(601) 426-4000

NPI assigned

Jul 12, 2006

Last updated

Feb 24, 2014By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Symvios Anesthesia LLCGroup PAC ID 8729446521, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sterling Surgical Hospital Hospital, Slidell, LA, CCN 190256

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Symvios Anesthesia LLC

  • Anesthesiology Physician
  • Slidell, LA
  • NPI 1427746619
  Medicare reassignment Care Compare group

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

• Doctors' Hospital of Slidell, LLC

  dba Cypress Pointe Hospital East

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1043392491
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1598790974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-399-6167",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "601-426-4000",
            "fax_number": "601-426-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JON",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R866388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MISSISSIPPI",
            "identifier": "412044822",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04574019",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Paul Wagner, PA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0501)
• Wal-Mart Stores, Inc. (Vision Center 30-0501)
• Walgreen Co (Walgreens #09037)
• Latoya Renee Walker, M.D.
• Wallace Drug Company Inc (Wallace Discount Drugs)
• Wallace Drug Company Inc (Dikets Professional Drugs)
• Dedra Danyale Wallace
• John M. Wallace, M.D.
• Cameron Mackenzie Walley, COTA

• Certified Registered Nurse Anesthetist in Laurel, MS
• Providers in Laurel, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.