Wallace Goforth, CRNA
NPI 1497295901 · Certified Registered Nurse Anesthetist · Carbondale, IL
Enrolled with Medicare as Practitioner - Certified Registered Nurse Anesthetist (crna) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wallace Goforth, CRNA is a Certified Registered Nurse Anesthetist provider in Carbondale, IL (NPI 1497295901).
Provider details
- NPI number
- 1497295901
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- License
- 1113831 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
9 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
285 Medicare services, 2024 (ranked within specialty)
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 methodology.
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 Other Procedure on Large Bowel Using an Endoscope00811 | 61 | $58 |
| Anesthesia for Exam of Colon Using an Endoscope00812 | 57 | $45 |
| Anesthesia for Lens Surgery00142 | 54 | $59 |
| Anesthesia for Other Procedure on Esophagus, Stomach, Or Upper Small Bowel Using an Endoscope00731 | 43 | $62 |
| Anesthesia for Injection, Drainage Or Aspiration Procedures on Spine Or Spinal Cord of Lower Back Accessed Through Skin Using Imaging Guidance01938 | 28 | $49 |
| Anesthesia for Procedure on Small and Large Bowel Using an Endoscope00813 | 27 | $75 |
Practice location
Mailing address
Additional practice locations (1)
- 12222 Merit Dr Ste 600Dallas, TX 75251-3294Phone: (972) 715-5000Fax: (972) 715-9976
Registry dates
- Enumerated
- 2017-03-02
- Last updated
- 2025-10-09
- Certified
- 2025-10-09
Frequently asked questions
- What is Wallace Goforth's NPI number?
- Wallace Goforth's National Provider Identifier (NPI) is 1497295901, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Wallace Goforth's specialty?
- Wallace Goforth is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Wallace Goforth located?
- Wallace Goforth's practice location on file with NPPES is 405 W Jackson St, Carbondale, IL 62901-1462.
- What is Wallace Goforth's phone number?
- The practice phone number listed in the NPPES registry for Wallace Goforth is (618) 549-0721.
- Does Wallace Goforth accept Medicare?
- Wallace Goforth is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Wallace Goforth's NPI active?
- Yes — Wallace Goforth's NPI (1497295901) is active in the NPPES registry as of the last update on 2025-10-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.