CHARLES F. WALLER (NPI# 1760455265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760455265 |
| Entity Type | Individual |
| Full Name | CHARLES F. WALLER |
| Credential | CRNA |
| Practice Address |
321 N Bailey Ave Fort Worth TX 76107-1001 |
| Practice Telephone | 8173788573 |
| Mailing Telephone | 8173788573 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 564644 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS | 83479U | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861528929 | Charles Milton Waller | Dentist | 272 Blue Haven Beach Rd, Camdenton, MO 65020-2123 | 2007-02-25 |
| 1306841341 | Charles Waller | Emergency Medicine | 218 Bass Ln, Benton, KY 42025-5824 | 2005-06-16 |
| 1659866556 | Charles Cutez Waller | Counselor | 1695 Main St, Springfield, MA 01103-1348 | 2018-06-25 |
| Street Address |
321 N BAILEY AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| 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 |
|---|---|---|---|---|
| 1689288524 | Pmr Crna Pllc | Nurse Anesthetist, Certified Registered | 5000 Alicia Dr, Fort Worth, TX 76133-7902 | 2020-09-08 |
| 1922622919 | Devontee Delishuanee Rayford | Nurse Anesthetist, Certified Registered | 3925 Crenshaw Ave, Fort Worth, TX 76105-4115 | 2020-06-04 |
| 1487292520 | Tran Dao | Nurse Anesthetist, Certified Registered | 8113 Rambler Rose St, Fort Worth, TX 76137-1294 | 2019-12-19 |
| 1093375305 | Desiree Michelle Silva | Nurse Anesthetist, Certified Registered | 7212 Park West Cir Apt 8210, Fort Worth, TX 76134-3570 | 2019-06-18 |
| 1255877551 | Virtue Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 209 Saint Louis Ave, Fort Worth, TX 76104-1231 | 2017-01-10 |
| 1326406919 | Tonie Durrah | Nurse Anesthetist, Certified Registered | 9713 Burwell Dr, Fort Worth, TX 76244-9531 | 2016-02-10 |
| 1730545658 | Erasmo Coutino | Nurse Anesthetist, Certified Registered | 917 W Broadus Ave, Fort Worth, TX 76115-2410 | 2016-01-07 |
| 1528423365 | John Ryan Nuckols | Nurse Anesthetist, Certified Registered | 6020 Portico Dr Apt 1527, Fort Worth, TX 76132-4189 | 2015-12-21 |
| 1194198457 | Nathan Boone Crick | Nurse Anesthetist, Certified Registered | 5264 Buffalo Gap Trl, Fort Worth, TX 76126 | 2015-11-09 |
| 1780061044 | Heather Taylor Ross | Nurse Anesthetist, Certified Registered | 5918 Siltstone Ln, Apt 616, Fort Worth, TX 76137-8003 | 2015-05-06 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
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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.