Aaron Matthew Vanderwall, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

12988 Issued in TN

Practice address

100 W 4TH St
Suite 310
Cookeville, TN 38501-2448

Phone

(931) 528-7877

Fax

(931) 526-3261

NPI assigned

Dec 10, 2007

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 3

Medicare fee-for-service enrollment

Enrolled in TN, IL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Anesthesiologists SCGroup PAC ID 6305744129, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

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.

• Associated Anesthesiologists, S.C.

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1558306480
  Medicare reassignment Care Compare group NPD
• Associated Anesthesiologists, SC

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1023612082
  NPD

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1992988208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "address_2": "SUITE 310",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012448",
            "telephone_number": "931-528-7877",
            "fax_number": "931-526-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "address_2": "SUITE 310",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012448",
            "telephone_number": "931-528-7877",
            "fax_number": "931-526-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWALL",
        "first_name": "AARON",
        "middle_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-10",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "12988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600132",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4168909",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P00459095",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirisha Reddy Vallepu
• Valley Healthcare LLC
• Shelby Lynn Van Epps, FNP-BC
• Jana Lynne Van Hooser
• James M Vance, PA
• Marianne Kay Vanhooser, LPC-MHSP
• Emily Ruth Varner
• Summer Morgan Varner, BA
• Varsity Drugs & Compounding, LLC
• Rebecca Erin Vaughn, NURSE PRACTITIONER

• Certified Registered Nurse Anesthetist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.