WALLACE ANESTHESIA SERVICES INCORPORATED (NPI# 1760945141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760945141 |
| Entity Type | Organization |
| Organization Name | WALLACE ANESTHESIA SERVICES INCORPORATED |
| Practice Address |
1311 N Mildred Rd Cortez CO 81321-2231 |
| Mailing Address |
Po Box 1085 Cortez CO 81321-1085 |
| Practice Telephone | 9705656666 |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | RACHEL RENEE WALLACE (DIRECTOR) |
| Authorized Official Telephone | 9182842163 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1311 N MILDRED RD |
| City | CORTEZ |
| State | CO |
| Zip Code | 81321-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962485599 | Kent R Aikin | Internal Medicine | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2005-11-29 |
| 1164037990 | Southwest Health System, Inc. | Medicare Defined Swing Bed Unit | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2020-09-09 |
| 1275157430 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2020-06-03 |
| 1992328074 | Southwest Health System, Inc. | Non-emergency Medical Transport (VAN) | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2020-05-22 |
| 1851863435 | Jennifer Kay Cropp | Pharmacist | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-12-20 |
| 1538630397 | Micheal Francisco | Physical Therapist | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-12-05 |
| 1558830638 | Jade Bryant | Pharmacist | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-11-18 |
| 1972078814 | Southwest Health System, Inc. | Nurse Practitioner | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-10-08 |
| 1659856169 | Southwest Health System, Inc. | Emergency Response System Companies | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-10-01 |
| 1679058184 | Southwest Health System, Inc. | Non-emergency Medical Transport (VAN) | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2018-10-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326667429 | Laurilyn Balfour Sturdevant | Dental Hygienist | 101 N Maple, Cortez, CO 81321 | 2020-04-09 |
| 1306231642 | Mesa View Retirement Home Inc. | Assisted Living Facility | 24760 County Road G, Cortez, CO 81321 | 2015-04-03 |
| 1528464765 | Patricia Nelson | Counselor | 691 E. Empire St., Cortez, CO 81321 | 2014-11-17 |
| 1417366808 | Summit Family Dental of Cortez, Pllc | Dentist | 111 S Sligo, Building A, Cortez, CO 81321 | 2014-08-11 |
| 1528480571 | Kelly Ogle | Registered Nurse | 17575 Road G, Cortez, CO 81321 | 2014-01-10 |
| 1316378821 | Beth A. Carter | Registered Nurse | 106 West North Street, Cortez, CO 81321 | 2013-12-09 |
| 1538596614 | Michael Daniel Grajeda | Physical Therapist | 111 N Park St Ste B, Cortez, CO 81321 | 2013-10-03 |
| 1275879876 | April L. Randle Md Inc | Internal Medicine | 215 Linden St, Suite D, Cortez, CO 81321 | 2012-12-31 |
| 1376827998 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 East Empire, Cortez, CO 81321 | 2011-09-30 |
| 1770879850 | Mark Holton | Marriage & Family Therapist | 1399 Cochita St, Cortez, CO 81321 | 2011-06-27 |
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| 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 |
|---|---|---|---|---|
| 1992245765 | Burke Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2017-02-27 |
| 1568884096 | Cody Burke | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2014-01-17 |
| 1669719175 | Rachel Renee Wallace | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321 | 2013-01-04 |
| 1497943658 | Robert Scott Steeves, LLC | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2007-10-11 |
| 1366540536 | Robert Scott Steeves | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2006-09-20 |
| 1972536977 | Kenneth Hurd Picillo | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2006-07-10 |
| 1912930918 | Alta Anesthesia P. C. | Nurse Anesthetist, Certified Registered | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979342 | Crna Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 7447 E Berry Ave Ste 100, Greenwood Village, CO 80111-2103 | 2019-08-30 |
| 1700390523 | Rocky Mountain Mobile Anesthesia Solutions, LLC | Nurse Anesthetist, Certified Registered | 300 Center Dr Ste G225, Superior, CO 80027-8625 | 2017-12-01 |
| 1790229193 | Freelance Anesthesia Colorado LLC | Nurse Anesthetist, Certified Registered | 18801 E Mainstreet Ste 150, Parker, CO 80134-3477 | 2016-12-05 |
| 1558803577 | Cheryl Botsford | Nurse Anesthetist, Certified Registered | 1899 Denver West Dr Apt 1423, Golden, CO 80401-3137 | 2016-11-08 |
| 1699225201 | Carlye Spaulding | Nurse Anesthetist, Certified Registered | 4680 Mariposa Ln, Cascade, CO 80809-1807 | 2016-10-06 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1750769295 | Advanced Specialty Anesthesia Colorado, LLC | Nurse Anesthetist, Certified Registered | 15121 East Mississippi, Aurora, CO 80012 | 2015-05-18 |
| 1669863627 | Ashley Brooke Billings | Nurse Anesthetist, Certified Registered | 11886 Cattle Ln, Parker, CO 80134-3065 | 2015-02-12 |
| 1154712511 | Katherine Faye Shulman | Nurse Anesthetist, Certified Registered | 6968 W Nova Dr, Littleton, CO 80128 | 2015-02-06 |
| 1245620830 | Tori Taylor | Nurse Anesthetist, Certified Registered | 112 W D St Ste 210-a, Pueblo, CO 81003-3461 | 2015-02-03 |
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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.