Karen Elaine Waller

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN 113668 Issued in OH

Practice address

613 Jett St
West Portsmouth, OH 45663-6213

Phone

(740) 858-2828

NPI assigned

Jun 23, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Ohio Home Care Program

  • Preferred Provider Organization
  • West Portsmouth, OH
  • NPI 1093995664
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1184885022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 JETT ST",
            "city": "WEST PORTSMOUTH",
            "state": "OH",
            "postal_code": "456636213",
            "telephone_number": "740-858-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 JETT ST",
            "city": "WEST PORTSMOUTH",
            "state": "OH",
            "postal_code": "456636213",
            "telephone_number": "740-858-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KAREN",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 113668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Stidham
• Hayle Swords
• Rachel Tackett
• Julia Ann Thomes
• Madison Brooke Walker, APRN-CNP
• Katelyn Michelle Ward
• Washington Township
• Washington-Nile Local School District
• Blaine A Weaver
• Brandon Tyler Weaver

• Licensed Practical Nurse in West Portsmouth, OH
• Providers in West Portsmouth, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.