Christopher Drew Waller

Primary specialty

PharmacistTaxonomy code 183500000X

License

017245 Issued in KY

Practice address

18586 Route 52
Fort Gay, WV 25514-7046

Phone

(304) 617-2242

NPI assigned

Apr 23, 2013

Last updated

Sep 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1114361938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18586 ROUTE 52",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255147046",
            "telephone_number": "304-617-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18586 ROUTE 52",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255147046",
            "telephone_number": "304-617-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "DREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "017245",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03234139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Vanderpool
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• Alena Rae Wallace, PCA
• Grace Wallace, PCA
• Nora Jean Wallace, PCA
• Amber Richeal Webb
• Mercedes Clements Weikle, PMHNP
• Debra Wellman
• Michelle Leigh Williams
• Matthew Lark Williamson

• Pharmacist in Fort Gay, WV
• Providers in Fort Gay, WV by specialty
• Pharmacist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.