RICHARD GARDNER WALLIS (NPI# 1124005012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124005012 |
| Entity Type | Individual |
| Full Name | RICHARD GARDNER WALLIS |
| Credential | MD |
| Practice Address |
6196 Lake Gray Blvd Suite 108 Jacksonville FL 32244-7503 |
| Mailing Address |
Po Box 863011 Orlando FL 32886-3011 |
| Practice Telephone | 9044212119 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2007-07-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | ME37752 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336425982 | Richard David Wallis | Nurse Practitioner | 6507 S Santa Fe Dr Bldg 22, Littleton, CO 80120-2910 | 2011-10-27 |
| 1215036181 | Richard D Wallis Jr. | Physical Therapist | 7580 Northcliff Ave, Building B Suite 700, Brooklyn, OH 44144-3270 | 2006-09-21 |
| Street Address |
6196 LAKE GRAY BLVD SUITE 108 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32244-7503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588017784 | Lake Gray Dialysis Center LLC | Clinic/Center | 6196 Lake Gray Blvd, Suite 112, Jacksonville, FL 32244-7503 | 2016-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013478247 | Saul Medina | Contractor | 8421 Cheswick Oak Ave, Jacksonville, FL 32244 | 2019-03-29 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1144735556 | Costco Wholesale Corporation | Pharmacy | 8000 Parramore Rd, Jacksonville, FL 32244 | 2017-12-07 |
| 1003287814 | South Jacksonville Dental Pllc | Dentist | 8440 Blanding Blvd, Jacksonville, FL 32244 | 2015-10-20 |
| 1326444340 | Laurie Lynn Scheid | Nurse Practitioner | 7855 Argyle Forest Blvd Ste 601, Jacksonville, FL 32244 | 2014-11-18 |
| 1114322260 | Candy Sharon Lucero | Occupational Therapist | 8563-2 Argyle Business Loop, Jacksonville, FL 32244 | 2014-10-31 |
| 1780959817 | Senior Helpers | In Home Supportive Care | 6327 Argyle Forest Blvd, Suite 3, Jacksonville, FL 32244 | 2012-03-22 |
| 1093831505 | Eduardo R Paat Sr. | Marriage & Family Therapist | 63394 Argyle Forest Blvd, Jacksonville, FL 32244 | 2007-03-22 |
| 1760524060 | Lauren Claxton Shivers | Nurse Practitioner | 8351 Westport Road, Jacksonville, FL 32244 | 2007-02-13 |
| 1427113968 | John F Bibb | Dentist | 6001 4 Argyle Forest Blvd, Jacksonville, FL 32244 | 2006-12-26 |
| Find all providers in zip 32244 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203451 | Brittany Clark | Anesthesiology | 220 Riverside Ave Unit 328, Jacksonville, FL 32202-4953 | 2019-09-11 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1699223453 | James Dennis Beeson | Anesthesiology | 9289 Rosewater Lane, Jacksonville, FL 32256 | 2016-09-21 |
| 1598129314 | Kaitlin Kamrowski | Anesthesiology | 653 West 8th Street, Faculty Clinic Building, 3rd Floor, Box Fc-12, Jacksonville, FL 32209 | 2016-04-07 |
| 1487017786 | Guy Kositratna | Anesthesiology | 653 West 8th Street, Jacksonville, FL 32209-6511 | 2016-04-04 |
| 1942603899 | Pain Medicine Physicians of Jacksonville, LLC | Anesthesiology | 10250 Normandy Boulevard, Suite 702, Jacksonville, FL 32221 | 2014-10-07 |
| 1063707784 | Chase Alan Kissling | Anesthesiology | Attn: Dmhrsi Team Bldg H 2005 Knight Lane, Navy Medicine Support Command, Jacksonville, FL 32212-0140 | 2011-06-10 |
| 1770804916 | Michael George Zakaroff | Anesthesiology | 2005 Knight Lane Bldh H, Navy Medicine Support Command Attn: Medical Staff Servi, Jacksonville, FL 32212-0140 | 2010-06-22 |
| 1427283522 | Darryl Crosswright Hall | Anesthesiology | 653 W. Eighth St., Faculty Clinic 3rd Floor, Jacksonville, FL 32209 | 2009-05-19 |
| 1578707071 | Puja Roy | Anesthesiology | 8268 Ashworth Ct, Jacksonville, FL 32256-3638 | 2009-04-28 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32244 |
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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.