Cleopatra Wallace, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN181636 Issued in GA

Practice address

777 Hemlock St
Macon, GA 31201-2102

Phone

(478) 633-2147

Fax

(478) 742-9670

NPI assigned

Aug 10, 2015

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

Other names 1

• Cleopatra W. Shirley Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164
• Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Piedmont Anesthesia LLC

  • Anesthesiology Physician
  • Stockbridge, GA
  • NPI 1700474244
  Medicare reassignment Care Compare group NPD
• Anesthesia Consultants of Savannah, PC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1679774343
  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  Medicare reassignment

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

• Coliseum Medical Center, LLC

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1598719643
  Care Compare affiliation
• Macon Northside Hospital, LLC

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1811940976
  Care Compare affiliation

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1679959852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-2147",
            "fax_number": "478-742-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CLEOPATRA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN181636",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN181636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLEOPATRA",
            "last_name": "SHIRLEY",
            "middle_name": "W.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rita Walker
• Shelby Walker, APRN
• Shemika Latrice Walker
• Trisha Jeanine Walker, BCBA
• Richard Alan Wall II
• Danielle Wallace
• Franc Wallace, MD
• Heather E Wallace
• Lisa Marie Wallace, CRNA
• William Wallace Jr., MD

• Certified Registered Nurse Anesthetist in Macon, GA
• Providers in Macon, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.