Joseph M Wallis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

39516 Issued in WV

Practice address

1340 Hal Greer Blvd
Huntington, WV 25701-3800

Phone

(304) 399-2960

NPI assigned

Nov 27, 2006

Last updated

Jul 8, 2007By 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 4

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Surgical Hospital, LLCGroup PAC ID 6800887092, 30 clinicians

Northstar Anesthesia of West Virginia PLLCGroup PAC ID 2668750241, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camc Charleston Surgical Hospital Hospital, Charleston, WV, CCN 510091

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17503/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/charles-8f0482a8

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.

• Charleston Surgical Hospital, LLC

  dba Charleston Surgical Hospital

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1104904143
  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of West Virginia, PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1821448150

  Nurse Anesthetist, Certified Registered, WV

  Medicare reassignment Care Compare group NPD
• Cabell Huntington Hospital Inc

  dba Cabell Huntington Hospital Anesthesia

  • Anesthesiology Physician
  • Huntington, WV
  • NPI 1275576373

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Oasis Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Ironton, OH
  • NPI 1720470792

  Nurse Anesthetist, Certified Registered, WV

  Medicare reassignment NPD
• Cabell Huntington Hospital Inc

  • Home Health Agency
  • Huntington, WV
  • NPI 1669558904
  NPD
• Charleston Surgical Hospital, LLC

  dba CAMC Charleston Surgical Hospital

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1669429965
  NPD
• Charleston Surgical Hospital Healthcare Group, PLLC

  • Surgery Physician
  • Charleston, WV
  • NPI 1285131144
  NPD (past)
• Day Surgery Limited Liability

  • Ambulatory Surgical Clinic/Center
  • Charleston, WV
  • NPI 1730296997
  NPD (past)

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

• Charleston Surgical Hospital, LLC

  dba CAMC Charleston Surgical Hospital

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1669429965
  Care Compare affiliation

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790851368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 714960",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432714960",
            "telephone_number": "205-322-1808",
            "fax_number": "205-322-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HAL GREER BLVD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013800",
            "telephone_number": "304-399-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "39516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067254000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0343248",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "P00258527",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74433558",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Troy Wallace, M.D.
• William C Wallace, MD
• Amy Jo Waller
• Debra Wallin
• Aleacha Faith Wallington, DPT
• Ashlee E Walls, LPC
• Nicole Walls
• April D Walters
• Clara Walters
• Jorden Walters

• Certified Registered Nurse Anesthetist in Huntington, WV
• Providers in Huntington, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.