Angela O Waller, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP65978 Issued in NM

Practice address

300 Highland Blvd
Suite B
Natchez, MS 39120-4600

Phone

(601) 304-2421

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS, NM, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Humboldt General HospitalGroup PAC ID 5193709798, shared by 5 NPIs, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Humboldt General Hospital Hospital, Winnemucca, NV, CCN 291308
• La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as apm

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Natchez Clinic Company LLC

  • Internal Medicine Physician
  • Natchez, MS
  • NPI 1881003184
  Medicare reassignment NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Lordsburg, NM
  • NPI 1306843180
  Medicare reassignment NPD
• DHHS PHS Naihs Chinle Comprehensive

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Silver City, NM
  • NPI 1255324562
  NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Silver City, NM
  • NPI 1467971986
  NPD
• Laguna Healthcare Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Paraje, NM
  • NPI 1386246221
  NPD
• Laguna Healthcare Corporation

  • Family Medicine Physician
  • Paraje, NM
  • NPI 1962001024
  NPD
• Natchez Hma Physician Management LLC

  • Family Medicine Physician
  • Natchez, MS
  • NPI 1386684199

  Nurse Practitioner

  NPD (past)
• Natchez Regional Clinic

  • Family Medicine Physician
  • Natchez, MS
  • NPI 1891982435
  NPD (past)
• Premier Health & Wellness Clinic

  • Primary Care Nurse Practitioner
  • Natchez, MS
  • NPI 1366108805
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Humboldt General Hospital

  • Critical Access Hospital
  • Winnemucca, NV
  • NPI 1750498010
  Care Compare affiliation
• La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1053684555
  Care Compare affiliation
• La Paz Regional Hospital Inc., Dba Parker Podiatry

  • Podiatrist
  • Parker, AZ
  • NPI 1568875771

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1194774190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DEMOSS STREET",
            "city": "LORDSBURG",
            "state": "NM",
            "postal_code": "880454600",
            "telephone_number": "575-542-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HIGHLAND BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204600",
            "telephone_number": "601-304-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANGELA",
        "middle_name": "O",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP04732",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP65978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1343447",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04705271",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Caleb Walker, DPT
• Kenitra Wallace, FNP
• Hazel M Washington, FNP
• Tami Yvette Washington
• We Care Express LLC
• Danita Ronique Weary, M.D.
• Jerel Lee West Jr., P.T.

• Family Nurse Practitioner in Natchez, MS
• Providers in Natchez, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.