NPI age
14 years
Enumerated 2011-09-12
● Active
Type 1 · Individual
MR. Ryan C. Wallentine, PA-AA
Wallentine is 1 of 49 anesthesiologist assistant providers in MacOn and 1 of 1530 in Georgia.
Primary specialty
Anesthesiologist Assistant
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2013-06-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1530 active anesthesiologist assistant providers in Georgia.
NPI age
14 years
↑ 2 yr above median (12 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
22% of peers hold subspecialties
NPI lifetime · 2011 → 2026
2011-09Enumerated in NPPES
2011
2026
Where they practice
Practice location
380 Hospital Dr, Suite 410
MacOn, GA 31217
Mailing address
Po Box 2564
MacOn, GA 312032564
Specialties
-
Anesthesiologist Assistant PrimaryAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 580628385 | TRICARE |
| 01 (GA) | P01003812 | RAILROAD MEDICARE |
| 05 (GA) | 003114063C | |
| 05 (GA) | 003114063D | |
| 05 (GA) | 003114063B | |
| 05 (GA) | 003114063A | |
| 01 (GA) | 635417 | WELLCARE |
Practice context
Part of a multi-provider practice. 44 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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