Wallace Anesthesia Services Incorporated

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

WALLACE ANESTHESIA SERVICES INCORPORATED

Practice address

1311 N Mildred Rd
Cortez, CO 81321-2231

Phone

(970) 565-6666

NPI assigned

Apr 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rachel Renee Wallace, CRNA

Title

Director

Phone

(918) 284-2163

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1760945141",
    "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": "813212231",
            "telephone_number": "970-565-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE ANESTHESIA SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "918-284-2163",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Christopher Vivolo, D.O.
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walgreen Co.
• Edward Stuart Walker, DDS
• Rachel Renee Wallace, CRNA
• Walmart Inc.
• Liching Pi Wang
• Crystal Ward, RPH
• Kimberly Ann Washburn, N.P.

• All providers in Cortez, CO
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.