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

Jonathan O Wallace, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1609821156

Jonathan O Wallace, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Mobile, Alabama. Qualified in 2005, 21 years ago. Practices with Anesthesiologists Associated PC, a 414-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
21
Licensed in
AL
In the registry since
2006
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone: (251) 432-4497
Fax: (251) 432-0577
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 1101813 (AL)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 1101813 (AL)

Record details

NPI number1609821156
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMay 23, 2006
Last updated in NPPESSeptember 11, 2025
Mailing addressPo Box 934369, Atlanta, GA 31193-0001

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Anesthesiologists Associated Pc — 414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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