RICHARD ANTHONY WALLACE CRNA
NPI 1629031992
Nurse Anesthetist, Certified Registered in Harriman, TN

Q: What is Richard Wallace's NPI number?

The NPI number for Richard Wallace is 1629031992. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Q: What is Richard Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Richard Wallace was last updated on September 25, 2013. 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.

Active since April 08, 2006

8045 ROANE MEDICAL CENTER DR, HARRIMAN, TN 37748(865) 316-1000 Get Directions Write a Review

NPPES record last updated: September 25, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Richard Anthony Wallace Crna NPPES

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

RICHARD ANTHONY WALLACE CRNA (NPI 1629031992) is an individual nurse anesthetist, certified registered in Harriman, Tennessee, licensed in Tennessee (9332) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1629031992

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameRICHARD ANTHONY WALLACECredential: CRNA

Location Address8045 ROANE MEDICAL CENTER DRHarriman, TN 37748-8333

Mailing Address969 Oak Ridge Tpke # 316Oak Ridge, TN 37830-8832 · (865) 256-7711 · Fax (866) 548-0571

Phone(865) 316-1000

Sole ProprietorYes

Enumeration DateApril 8, 2006

Last NPPES UpdateSeptember 25, 2013

✔ NPI 1629031992 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

License✔ Licensed in TN · 9332

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.

8045 ROANE MEDICAL CENTER DR, Harriman, TN 37748

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Other Identifiers 15

Medicaid1527480TN

Other171975592453TN · Humana

Other4317478TN · Bcbs - Blue Preferred

Other4317478TN · Bcbs - Blue Select

Other4317478TN · Bcbs - Tenncare Select

Other4317478TN · Bcbs - Medicare Advantage (blueadvantage)

Other0454102553TN · Tricare South Humana Military

Medicare PIN1629031992TN

Other3037582TN · Cigna

Other4317478TN · Bcbs - Bluecare

Other616644300TN · Dept Of Labor Woker's Comp - Feca Program

Other1527480TN · Tenncare, Effective 4/5/12

Other454102553TN · Humana Gold

Other4317478TN · Bcbs - Cover Tennessee

Other616644300TN · Dept Of Labor Worker's Comp - Deeoic Program

Other Providers at the Same Location NPPES 10

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

JENNIFER MCHARDY MD

Emergency Medicine