Active NPI
Victoria Lauren Vanderwall, RN
- Certified Registered Nurse Anesthetist
- Chattanooga, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 30423
- Practice address
- 2525 Desales Ave
Chattanooga, TN 37404-1161 - Phone
- (423) 290-8227
- NPI assigned
- Apr 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 214818 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 30423 | TN | Primary |
Addresses
Primary practice location
2525 Desales Ave
Chattanooga, TN 37404-1161
Mailing address
164 Maple St
Dayton, TN 37321-6080
Phone (423) 290-8227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525
4710 Battlefield Pkwy
Ringgold, GA 30736-5164
Phone (423) 495-2525
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.27 of 100
- Quality
- 92.6
- Promoting interoperability
- 93.23
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214818 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Tennessee, P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Memorial Health Partners Foundation, Inc | Current | Accepting new patients | |
| Memorial Health Partners Foundation Inc | Current | Accepting new patients | |
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients |
Locations
611 E Villanow St
La Fayette, GA 30728
Phone (706) 638-1606
2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620
5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586
2051 Hamill Rd
Ste 301
Hixson, TN 37343
Phone (423) 870-3376
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Chattanooga, TN
- NPI 1922053545
GA
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1245279777
Nurse Anesthetist, Certified Registered
-
dba CHI Memorial Family Practice Associates - Lafayette
- Rural Health Clinic/Center
- La Fayette, GA
- NPI 1760632780
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Memorial Hospital Hixson
- General Acute Care Hospital
- Hixson, TN
- NPI 1083778633
-
dba Memorial Hospital
- General Acute Care Hospital
- Chattanooga, TN
- NPI 1255428736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1831770684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 MAPLE ST",
"city": "DAYTON",
"state": "TN",
"postal_code": "373216080",
"telephone_number": "423-290-8227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 DESALES AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041161",
"telephone_number": "423-290-8227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERWALL",
"first_name": "VICTORIA",
"middle_name": "LAUREN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-14",
"last_updated": "2021-12-06",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "214818",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "30423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
- Sharon Vancleave, SLP/CCC
- Douglas L Vanderbilt, MD
- Cynthia Dana Vandergriff
- Miranda Danielle Vandergriff, LPN
- Lisa S Vanderwall, CRNA
- Vanessa Moyes DDS (Dentistry of Chattanooga PLLC)
- Adam John Vanmason, M.D.
- Traci Vannostran, M.S., CCC-SLP
- Harsha Gadadhar Vardhana, M.D.
- Ana Laura Varela Windemuller, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.