Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Theodore Alan Wong, CRNA, RN

Individual provider Registered Nurse · NPI 1124601950

Dr. Theodore Alan Wong, CRNA, RN is a Certified Registered Nurse Anesthetist (CRNA) in Birmingham, Alabama. Qualified in 2021, 5 years ago. Practices with Blue Eagle Anesthesia Inc a Professional Corporation, a 25-clinician group and accepts Medicare assignment. Licensed in Alabama and California.

Years since qualifying
5
Licensed in
AL, CA
In the registry since
2021
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

1802 6th Ave S
Birmingham, AL 35233-1932
Phone: (205) 934-3411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 134436 (AL)
Registered Nurse Taxonomy 163W00000X · Licence 95238443 (CA)

Record details

NPI number1124601950
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA , RN
Sole proprietorYes
NPI enumeratedApril 29, 2021
Last updated in NPPESFebruary 11, 2022
Certification dateMay 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Blue Eagle Anesthesia Inc A Professional Corporation — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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