Individual provider Active NPI

Kerry Wallace Semmes, CRNA

  • Certified Registered Nurse Anesthetist
  • Gastonia, NC
National Provider Identifier
1932499498
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
087186 Issued in NC
Practice address
2525 Court Dr
Gastonia, NC 28054-2140
Phone
(704) 834-4113
NPI assigned
Apr 18, 2011
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 087186 NC Primary

Addresses

Primary practice location

2525 Court Dr
Gastonia, NC 28054-2140

Mailing address

1550 Union Rd Ste B
Gastonia, NC 28054-5522
Phone (704) 864-8772

Other names 1

  • Kerry Diane Wallace Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110721000330 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466620216 Reassigns benefits to 2 organizations
I20190912001967 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466620216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3869NCMDOccupational Therapist
087186NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Surgery Center Anesthesia Providers PC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Northern Colorado Anesthesia Professionals PLLC CurrentSince Aug 1, 2019 Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Gaston Anesthesia Associates, P.a. Past Accepting new patients

Locations

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 922-3622

1750 E Ken Pratt Blvd
Longmont, CO 80504
Phone (720) 718-7000

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

400 10th St E
Waconia, MN 55387

320 Lillington Ave
Ste 101
Charlotte, NC 28204
Phone (704) 332-1574

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1932499498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 UNION RD STE B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545522",
            "telephone_number": "704-864-8772",
            "fax_number": "704-866-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-834-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMMES",
        "first_name": "KERRY",
        "middle_name": "WALLACE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "087186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "WALLACE",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.