Kelsey A Wallace (NPI# 1013576990, PAC ID# 6709111321) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1013576990 |
| PAC ID by PECOS | 6709111321 |
| Professional Enrollment ID | I20190718000338 |
| Full Name | Kelsey A Wallace |
| Organization Legal Name | MEMORIAL MEDICAL CENTER |
| Address |
701 N 1st St Springfield IL 62781-0001 |
| Phone Number | 2177883755 |
| Gender | F |
| Graduation Year | 2019 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 7315835949 |
| Number of Group Practice Members | 76 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140148 | MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 701 N 1st St, Springfield, IL 62781-0001 | 2177883755 | MEMORIAL MEDICAL CENTER |
| Organization Legal Name | MEMORIAL MEDICAL CENTER |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah I Sloan | Family Medicine | Memorial Medical Center | 501 N 1st St, Springfield, IL 62702-5115 |
| Sarah J Karraker | Clinical Social Worker | Memorial Medical Center | 932 N Rutledge St, Springfield, IL 62702-3721 |
| Mercedes Schultz | Obstetrics/gynecology | Memorial Medical Center | 815 N Virginia St, Port Lavaca, TX 77979-3025 |
| Carol A Gorden | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Ann R Larson | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Don P Bunnell | Internal Medicine | Memorial Medical Center | 815 N Virginia St, Port Lavaca, TX 77979-3025 |
| Heidi L Phillips | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Robert W Cox | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Amber H Smith | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Elise Berard Arnold | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Street Address |
701 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip | 62781-0001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason A Grauer | Nurse Practitioner | Midwest Emergency Department Specialists Ltd | 701 N 1st St, Springfield, IL 62781-3757 |
| Carol A Gorden | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Ann R Larson | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Christopher Inabnit | Emergency Medicine | Midwest Emergency Department Specialists Ltd | 701 N 1st St, Springfield, IL 62781-3757 |
| Heidi L Phillips | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Jeff F Wang | Pathology | Pathology Associates of Central Illinois Ltd | 701 N 1st St, Springfield, IL 62781-0001 |
| Christopher Matthew Bradbury | Radiation Oncology | University Radiologists Sc | 701 N 1st St, Springfield, IL 62781-0001 |
| Santhi B Arikati | Internal Medicine | Springfield Clinic LLP | 701 N 1st St, D116, Springfield, IL 62702-3757 |
| Sharon C Smith | Emergency Medicine | Midwest Emergency Department Specialists Ltd | 701 N 1st St, Springfield, IL 62781-3757 |
| Robert W Cox | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber H Smith | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Elise Berard Arnold | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| William K Janes | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Emily A Jones Robson | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Jayne E Fiaush | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Sravanthi S Pallapothu | Physical Therapy | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Jean M Jennings | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Joshua A Baumberger | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| James Matthew Perkins | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Scott A Kuntz | Certified Registered Nurse Anesthetist (crna) | Memorial Medical Center | 701 N 1st St, Springfield, IL 62781-0001 |
| Find all physicians in zip 62781 | |||
| City | SPRINGFIELD |
| Zip Code | 62781 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | SPRINGFIELD + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Kelsey A Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.