Marty Wallace, CRNA
NPI 1164674743 · Certified Registered Nurse Anesthetist · Johnson City, TN
Enrolled with Medicare as Practitioner - Certified Registered Nurse Anesthetist (crna) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Marty Wallace, CRNA is a Certified Registered Nurse Anesthetist provider in Johnson City, TN (NPI 1164674743).
Provider details
- NPI number
- 1164674743
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- License
- APN13700 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
17 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
76 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Anesthesia for Extensive Surgery on Spine00670 | 60 | $235 |
| Anesthesia for Other Procedure on Lower Spine00630 | 16 | $160 |
Typical Medicare-allowed amounts for these services range $160–$235 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$32 across 2 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-10-15
- Last updated
- 2009-11-20
Frequently asked questions
- What is Marty Wallace's NPI number?
- Marty Wallace's National Provider Identifier (NPI) is 1164674743, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Marty Wallace's specialty?
- Marty Wallace is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Marty Wallace located?
- Marty Wallace's practice location on file with NPPES is 1114 Sunset Dr, Johnson City, TN 37604-2969.
- What is Marty Wallace's phone number?
- The practice phone number listed in the NPPES registry for Marty Wallace is (423) 283-0776.
- Does Marty Wallace accept Medicare?
- Marty Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Marty Wallace's NPI active?
- Yes — Marty Wallace's NPI (1164674743) is active in the NPPES registry as of the last update on 2009-11-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.