Active NPI
Algernon Anthony Stephen Waller
- Driver
- Melville, NY
National Provider Identifier
1245734805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 68 S Service Rd Ste 100
Melville, NY 11747-2350 - Phone
- (631) 629-2493
- Fax
- (631) 629-6945
- NPI assigned
- Mar 20, 2018
- Last updated
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Primary |
Addresses
Primary practice location
68 S Service Rd Ste 100
Melville, NY 11747-2350
Mailing address
4 Denmark CT
Huntington, NY 11743-4734
Phone (631) 334-9572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 3 Amigos Taxi & Limousine, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1245734805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 DENMARK CT",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434734",
"telephone_number": "631-334-9572",
"fax_number": "631-629-6945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 S SERVICE RD STE 100",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472350",
"telephone_number": "631-629-2493",
"fax_number": "631-629-6945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER",
"first_name": "ALGERNON",
"middle_name": "ANTHONY STEPHEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-20",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.