ROBERT WALLACE (NPI# 1003950288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003950288 |
| Entity Type | Individual |
| Full Name | ROBERT WALLACE |
| Credential | CRNA |
| Practice Address |
367 Hospital Blvd Jackson TN 38305-2080 |
| Practice Telephone | 7316612227 |
| Mailing Telephone | 7316612227 |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2011-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 53447 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316430176 | Robert E Wallace | Case Manager/Care Coordinator | 283 Old Colliers Way, Weirton, WV 26062-4073 | 2018-06-07 |
| 1801337134 | Robert William Wallace II | Student in an Organized Health Care Education/Training Program | 204 N Silver Maple Dr, Slidell, LA 70458-5483 | 2017-03-20 |
| 1780015610 | Robert G. Wallace | Radiology | 1130 Goat Rock Road, Fortson, GA 31808 | 2013-12-03 |
| 1972947257 | Robert William Wallace | Registered Nurse | 40 Ridge Dr, West Hurley, NY 12491-5627 | 2013-04-17 |
| 1487991683 | Robert J Wallace | Acupuncturist | 1619 W Montrose, Chicago Holistic Medicine, Chicago, IL 60613 | 2013-01-08 |
| 1154582773 | Robert Lee Wallace | Counselor | 110 S Hancock St, Rockingham, NC 28379-3675 | 2008-06-17 |
| 1649484635 | Robert Jay Wallace | Obstetrics & Gynecology | 6250 Alfred Harrell Hwy, Bakersfield, CA 93308-9654 | 2007-05-09 |
| 1023132644 | Robert S Wallace | Chiropractor | 7 Centre Dr, Suite 10, Monroe, NJ 08831-1565 | 2007-03-19 |
| 1750443024 | Robert Wallace | Pharmacist | 12421 W Denton Ave, Litchfield Park, AZ 85340-3435 | 2006-12-14 |
| 1922113174 | Robert Vernon Wallace | Family Medicine | 400 Lee Blvd, Lehigh Acres, FL 33936-4923 | 2006-08-20 |
| Street Address |
367 HOSPITAL BLVD |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-2080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922094283 | Julie D Joyce | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Regional Hospital of Jackson, Jackson, TN 38305-2080 | 2005-09-22 |
| 1457824468 | West Tennessee Healthcare Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2019-01-03 |
| 1093188864 | Atlas Emergency Physicians, Pllc | Physician Assistant | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2015-11-03 |
| 1093188971 | Red Embers Emergency Physicians, LLC | Physician Assistant | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2015-11-02 |
| 1215354055 | Jackson Anesthesia and Perioperative Consultants | Anesthesiology | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2014-03-18 |
| 1558797993 | Valley Grove Inpatient Services, Pllc | Internal Medicine | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2013-09-17 |
| 1033456884 | Charity Reasons | Nurse Practitioner | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2013-01-14 |
| 1780965103 | Ashley Dillingham Hayes | Nurse Anesthetist, Certified Registered | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2011-08-30 |
| 1780906560 | Tennessee Em-i Medical Services, PC | Nurse Practitioner | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2010-02-22 |
| 1700063351 | Norberto J Celarie | Emergency Medicine | 367 Hospital Blvd, Jackson, TN 38305-2080 | 2008-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295232304 | Trumania Inc | Nurse Anesthetist, Certified Registered | 223 Clinton Rd Ste 204, Jackson, CA 95642-2680 | 2018-04-06 |
| 1902287501 | Timothy Parrish | Nurse Anesthetist, Certified Registered | 27 Red Deer Cv, Jackson, TN 38305-6485 | 2015-06-09 |
| 1821345398 | Denicia Maria Rankin | Nurse Anesthetist, Certified Registered | 88 Boyd Dr, Jackson, TN 38305-2152 | 2012-08-14 |
| 1437425717 | Sheela Federici | Nurse Anesthetist, Certified Registered | 545 Rutledge St, Jackson, MI 49203-1113 | 2012-03-30 |
| 1164611240 | Yvette George | Nurse Anesthetist, Certified Registered | 105 F Stonebrook Pl, Jackson, TN 38305 | 2007-10-15 |
| 1194843110 | Patricia Lynn Koprivica | Nurse Anesthetist, Certified Registered | 5919 Amber, Jackson, MI 49201-8389 | 2007-03-27 |
| 1215055454 | Eunai Danek | Nurse Anesthetist, Certified Registered | 2571 Cascade Creek Dr, Jackson, MI 49203-3771 | 2007-03-26 |
| 1508950064 | Mark Combs | Nurse Anesthetist, Certified Registered | 205 North East Ave, Anesthesia Department, Jackson, MI 49201 | 2006-10-02 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| 1932292596 | James Gerard Brown | Nurse Anesthetist, Certified Registered | Foote Hosp., 205 North East Avenue, Jackson, MI 49201-1753 | 2006-10-02 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.