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DEBORAH A WALLACE CRNA
NPI 1184667388
Nurse Anesthetist, Certified Registered in Lawrenceville, GA

Active since June 14, 2006Accepts Medicare Assignment
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046(770) 277-3056(855) 204-5244 Get Directions Write a Review

NPPES record last updated: April 29, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Deborah A Wallace Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEBORAH A WALLACE CRNA (NPI 1184667388) is an individual nurse anesthetist, certified registered in Lawrenceville, Georgia, licensed in Georgia (RN040043) and active in the NPI registry since June 2006. She is a graduate of Other (1985).

NPPES Registry Identity

NPI1184667388
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameDEBORAH A WALLACECredential: CRNA
Location Address1000 MEDICAL CENTER BLVDLawrenceville, GA 30046-0000
Mailing AddressPo Box 551420Fort Lauderdale, FL 33355-1420 · (800) 243-3839 · Fax (954) 839-2569
Phone(770) 277-3056
Fax(855) 204-5244
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateJune 14, 2006
Last NPPES UpdateApril 29, 2014
✔ NPI 1184667388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses✔ Licensed in GA · RN040043✔ Licensed in GA · R040043
Definition
(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.
1000 MEDICAL CENTER BLVD, Lawrenceville, GA 30046
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Other Identifiers 4

Medicare ID-Type Unspecified43ZCBFQ55GA
Medicare UPINS41056GA
Medicare PIN2021436907GA
Medicaid000511167CGA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Deborah A Wallace Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911035282
PECOS Enrollment IDI20100506000468

Medicare Billing Reassignments

3

Medicare enrollment records show Deborah Wallace reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sleep Ezzy
0.5 mi
Pain Medicine
892 LEGACY PARK DR
Lawrenceville, GA 30043
  • Reassigned Medicare billing, Georgia enrollment
  • 76 clinicians in this Medicare group
NPI 1154852820 (770) 962-3642
American Anesthesiology Associates Of Georgia, LLC
11 mi
Anesthesiology
2171 WEST PARK COURT, SUITE A
Stone Mountain, GA 30087
  • Reassigned Medicare billing, Georgia enrollment
  • 650 clinicians in this Medicare group
NPI 1528068673 (678) 514-1991
North Atlanta Professional Services LLC
20 mi
Psychologist
1000 JOHNSON FERRY RD NE
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 783 clinicians in this Medicare group
NPI 1316959869 (855) 709-4535

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT E BLACK III MD
Anesthesiology
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 277-3056
HEATHER GAIL KOTULA PAAA
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 963-9905
MR. THOMAS J GLANCY PA-AA
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 277-3056
MS. ANDREA PEYTON MOE PA
Physician Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-4357
MRS. KATHERINE ELAINE CAMPBELL THOMAS NP
Nurse Practitioner (Adult Health)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County No phone listed
SOLOMON GEZAHGN ABEBE
Nurse Practitioner (Psychiatric/Mental Health)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (229) 299-7476
CHINWE OGBODO
Nurse Practitioner (Family)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-5280
KAPILDEV PRASAD PAAA
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Gwinnett County (770) 277-3056

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deborah Wallace's NPI number?

The NPI number for Deborah Wallace is 1184667388. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is Deborah Wallace located?

Deborah Wallace practices at 1000 Medical Center Blvd, Lawrenceville, GA 30046. The listed phone number is (770) 277-3056.

What is Deborah Wallace's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Deborah Wallace enrolled in Medicare?

Yes. Deborah Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Deborah Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deborah Wallace reassigns Medicare benefits to 3 organizations: Sleep Ezzy (Lawrenceville, GA), American Anesthesiology Associates Of Georgia, LLC (Stone Mountain, GA) and North Atlanta Professional Services LLC (Atlanta, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Deborah Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Deborah Wallace was last updated on April 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.