Active NPI
Wallace Eugene Ralston, CRNA
- Certified Registered Nurse Anesthetist
- Marshall, MO
National Provider Identifier
1972556447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 152532
- Practice address
- 2305 S 65 Highway
Marshall, MO 65340 - Phone
- (660) 886-3554
- Fax
- (660) 831-3308
- NPI assigned
- May 18, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2020034592 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 152532 | MO | Primary |
Addresses
Primary practice location
2305 S 65 Highway
Marshall, MO 65340
Mailing address
2305 South 65 Highway
Marshall, MO 65340-2640
Phone (660) 886-7431
Other practice location 1
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-9382
Other practice location 2
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1127
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30004543120001 | Medicaid | KS | |
| 918782004 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | WallaceRalston@fitzgibbon.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, KS
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040811000239 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0941272819 | Reassigns benefits to 4 organizations |
| I20110811000682 | KS | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 0941272819 |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- John Fitzgibbon Memorial Hospital IncTruman Medical Center Incorporated
Practice addresses (Care Compare)
2305 S Hwy 65
Marshall, MO 65340-3702
Phone (660) 831-8414
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7000
Hospital & facility affiliations
- Fitzgibbon Hospital
- Cedar County Memorial Hospital
- Truman Medical Center Hospital Hill
- Bothwell Regional Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020034592 | MO | MD | Nurse Practitioner |
Practice roles
Locations
1401 S Park St
El Dorado Springs, MO 64744
Phone (417) 876-2511
7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485
2301 Holmes St
Kansas City, MO 64108
7900 Lees Summit Rd
Ste 374
Kansas City, MO 64139
4321 Washington St
Ste 5700
Kansas City, MO 64111
Phone (816) 561-2000
2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730
Interoperability endpoints
- wallaceralston@fitzgibbon.cernerdirect.com
Organizations & group practices 34
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.
-
- General Acute Care Hospital
- Marshall, MO
- NPI 1730182478
-
- Rural Health Clinic/Center
- Pilot Grove, MO
- NPI 1073279873
-
- Clinic/Center
- Marshall, MO
- NPI 1093731986
-
- Rural Health Clinic/Center
- Marshall, MO
- NPI 1134752140
-
- Rural Health Clinic/Center
- Fayette, MO
- NPI 1316140494
-
- Multi-Specialty Clinic/Center
- Marshall, MO
- NPI 1346966454
-
- Psychiatric Hospital Unit
- Marshall, MO
- NPI 1558523068
-
- Home Health Agency
- Marshall, MO
- NPI 1760402572
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- El Dorado Springs, MO
- NPI 1720039605
Hospital
-
- Rural Health Clinic/Center
- Pilot Grove, MO
- NPI 1073279873
Hospital
-
- Rural Health Clinic/Center
- Marshall, MO
- NPI 1134752140
Hospital
-
- Rural Health Clinic/Center
- Fayette, MO
- NPI 1316140494
Hospital
-
- Multi-Specialty Clinic/Center
- Marshall, MO
- NPI 1346966454
Hospital
-
- General Acute Care Hospital
- Marshall, MO
- NPI 1730182478
Hospital
-
- Rural Health Clinic/Center
- Slater, MO
- NPI 1952611436
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1972556447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 SOUTH 65 HIGHWAY",
"city": "MARSHALL",
"state": "MO",
"postal_code": "653402640",
"telephone_number": "660-886-7431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 S 65 HIGHWAY",
"city": "MARSHALL",
"state": "MO",
"postal_code": "65340",
"telephone_number": "660-886-3554",
"fax_number": "660-831-3308"
}
],
"practiceLocations": [
{
"address_1": "7900 Lees Summit Rd",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641391236",
"country_code": "US",
"telephone_number": "816-404-9382",
"fax_number": "816-404-7142",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2301 Holmes St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082640",
"country_code": "US",
"telephone_number": "816-404-1127",
"fax_number": "819-404-1103",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RALSTON",
"first_name": "WALLACE",
"middle_name": "EUGENE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "2020034592",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "152532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30004543120001",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "918782004",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "WallaceRalston@fitzgibbon.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Wallace Ralston John Fitzgibbon Hospital Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2305 S 65 Highway",
"city": "Marshall",
"state": "MO",
"country_code": "US",
"postal_code": "65340",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marshall, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.