Active NPI
Nicholas Waldner
- Emergency Medicine Physician
- Greenville, SC
National Provider Identifier
1154905206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 89929
- Practice address
- 701 Grove Rd FL 1
Greenville, SC 29605-4210 - Phone
- (864) 455-7899
- Fax
- (864) 455-5474
- NPI assigned
- May 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 89929 | SC | Primary |
Addresses
Primary practice location
701 Grove Rd FL 1
Greenville, SC 29605-4210
Mailing address
300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8603
Other practice location 1
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Rush Medical College of Rush University, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1154905206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012899",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE RD FL 1",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054210",
"telephone_number": "864-455-7899",
"fax_number": "864-455-5474"
}
],
"practiceLocations": [
{
"address_1": "600 S Paulina St Ste 403",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606123806",
"country_code": "US",
"telephone_number": "312-942-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALDNER",
"first_name": "NICHOLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-05",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "89929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.