Justin C. Walley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R860609 Issued in MS

Practice address

1314 19TH Ave
Meridian, MS 39301-4116

Phone

(601) 703-9687

Fax

(601) 703-9920

NPI assigned

Oct 18, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in MS, AR, GA3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Tennessee, HSC, College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Hospitalist Medicine Physicians of Georgia - TCS, PCGroup PAC ID 3971024910, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104
• Neshoba County General Hospital Hospital, Philadelphia, MS, CCN 250043

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 and National Provider Directory roles.

• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Georgia - TCS, PC

  • Anesthesiology Physician
  • Columbus, GA
  • NPI 1033926191
  Medicare reassignment Care Compare group
• Lifelinc Anesthesia V, P.a.

  • Anesthesiology Physician
  • West Memphis, AR
  • NPI 1063907244

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ans Services of Arkansas PA

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1699558387
  NPD

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

• Anderson Regional Medical Center

  dba Baptist Anderson Regional Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1649226952
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1871674606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-9687",
            "fax_number": "601-703-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEY",
        "first_name": "JUSTIN",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R860609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02676766",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ricky Walker, ATHLETIC TRAINER
• Riley Morgan Walker, M.S,, CCC-SLP
• James Howard Wallace, MD
• Perry Wallace, MD
• Sherita Danielle Wallace, NP
• Theon Walley
• April Kristina Walters, APRN, ACNPC-AG
• Evelyn D Walters
• Kevin M. Ward, M.D.
• Leah Lindsley Ward, RN, MSN

• Certified Registered Nurse Anesthetist in Meridian, MS
• Providers in Meridian, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.