Rachel Renee Wallace, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C-APN.0001428-C-CRNA Issued in CO

Practice address

1311 N Mildred Rd
Cortez, CO 81321

Phone

(970) 555-6666

NPI assigned

Jan 4, 2013

Last updated

Aug 8, 2022By 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 SC, CO2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novus Colorado Professional CorporationGroup PAC ID 0840694774, 12 clinicians

Animas Anesthesia Associates LLCGroup PAC ID 2668668997, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Memorial Hospital Hospital, Cortez, CO, CCN 061327

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.

• Animas Anesthesia Associates LLC

  • Anesthesiology Physician
  • Durango, CO
  • NPI 1104148642
  Medicare reassignment Care Compare group NPD
• Novus Colorado Professional Corporation

  • Anesthesiology Physician
  • Cortez, CO
  • NPI 1437723640

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Animas Surgical Hospital, LLC

  dba Animas Physician Network

  • Emergency Medicine Physician
  • Durango, CO
  • NPI 1861721714

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Coastal Healthcare Resources Inc

  • Anesthesiology Physician
  • Florence, SC
  • NPI 1467635128

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  Nurse Anesthetist, Certified Registered, SC

  Medicare reassignment NPD
• Wallace Anesthesia Services Incorporated

  • Certified Registered Nurse Anesthetist
  • Cortez, CO
  • NPI 1760945141
  Authorized official Same address or phone
• Durango Surgery Center LLC

  dba Animas Surgical Center at Escalante

  • Ambulatory Surgical Clinic/Center
  • Durango, CO
  • NPI 1548870603
  NPD
• Anesthesia Network Services, LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1508199142
  NPD (past)

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

• Southwest Health System Inc

  dba Southwest Memorial Hospital

  • Critical Access Hospital
  • Cortez, CO
  • NPI 1649241571
  Care Compare affiliation
• Southwest Health System, Inc.

  dba Southwest Memorial Ambulance

  • Land Ambulance
  • Cortez, CO
  • NPI 1679058184

  Hospital

  Care Compare affiliation
• Southwest Health System, Inc.

  dba Southwest Memorial Ambulance

  • Non-emergency Medical Transport (VAN)
  • Cortez, CO
  • NPI 1992328074

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1669719175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35505 ROAD K.1",
            "city": "MANCOS",
            "state": "CO",
            "postal_code": "813288978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-555-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35505 Road K.1",
            "address_purpose": "LOCATION",
            "city": "Mancos",
            "state": "CO",
            "postal_code": "813288978",
            "country_code": "US",
            "telephone_number": "918-284-2163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1311 N Mildred Rd",
            "address_purpose": "LOCATION",
            "city": "Cortez",
            "state": "CO",
            "postal_code": "81321",
            "country_code": "US",
            "telephone_number": "970-555-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6839 S Canton Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741363402",
            "country_code": "US",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "RACHEL",
        "middle_name": "RENEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2022-08-08",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R0088890",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "C-APN.0001428-C-CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores, Inc. (Vision Center 30-0966)
• Walgreen Co (Walgreens #10370)
• Walgreen Co. (Walgreens #10370)
• Edward Stuart Walker, DDS
• Wallace Anesthesia Services Incorporated
• Walmart Inc. (Walmart Pharmacy 10-0966)
• Liching Pi Wang
• Crystal Ward, RPH
• Kimberly Ann Washburn, N.P.
• Jane Henninger Weiland, CACII

• Certified Registered Nurse Anesthetist in Cortez, CO
• Providers in Cortez, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.