Brenda Sue Waller, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101055485 Issued in VA

Practice address

2600 Memorial Ave Suite 201B
Lynchburg, VA 24501

Phone

(434) 528-0896

Fax

(434) 528-0896

NPI assigned

Jan 16, 2006

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

University of Pittsburgh School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pris, PLC

  • Physical Medicine & Rehabilitation Physician
  • Lynchburg, VA
  • NPI 1982930673
  NPD Authorized official
• Pris,PLC

  • Physical Medicine & Rehabilitation Physician
  • Lynchburg, VA
  • NPI 1891922928
  Authorized official Same address or phone
• Emc Health, LLC

  • Medical Specialty Clinic/Center
  • Petersburg, VA
  • NPI 1982321006
  NPD (past)
• Halifax Clinic Inc

  • Family Medicine Physician
  • Halifax, VA
  • NPI 1073786356
  NPD (past)
• White Oak Primary Care, Inc.

  • Primary Care Clinic/Center
  • Halifax, VA
  • NPI 1639799166
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1093794133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MEMORIAL AVE SUITE 201B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24501",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MEMORIAL AVE SUITE 201B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24501",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "BRENDA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101055485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Charles Preston Wall, LPC
• Deaven McGuire Wallace, MA, LPC
• Donald McQuire Wallace, DDS
• Kojo Wallace, MD
• William Miles Wallace
• Sandra Waller, CERTIFIED HAIR LOSS
• John Wallman, PT
• Mary Wallman, PT
• Matthew Robert Wallman, PA-C
• Evan Rhys Walsh

• Physical Medicine & Rehabilitation Physician in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.