Ansley Waller, MSN, APRN, AGACNP-BC

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

1097452 Issued in TX

Practice address

2425 Highway 121 Ste 201
Bedford, TX 76021-5011

Phone

(817) 283-5166

Fax

(817) 283-5176

NPI assigned

Sep 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Nurse Practitioner

Education

Texas Tech University Health Science Center School of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, 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.

• NTKC-DFW, PLLC

  dba North Texas Kidney Consultants

  • Nephrology Physician
  • Arlington, TX
  • NPI 1598090854
  NPD

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1285354985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 105",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518755",
            "telephone_number": "817-488-6812",
            "fax_number": "817-251-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HIGHWAY 121 STE 201",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215011",
            "telephone_number": "817-283-5166",
            "fax_number": "817-283-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANSLEY",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1097452",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "TX",
            "license": "1097452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ntkc.net",
            "affiliation": "N",
            "address_1": "2425 Highway 121 Ste 201",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760215011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walgreen Co (Walgreens #03881)
• Usha Walia, M.D
• Joel Wayne Walker, M.D.
• Ulizabeth Monique Walker, LPC
• Nichelle M. Wall, M. ED., LPC, CST-C
• Sharon Walters, RN, CNS, PMHNP
• Terry Lynne Walters, PH.D.
• Lindsey Nicole Wamsley, MA, LPC
• Jackie Diem Wang, O.D.
• Richard P. Ward Jr., M.D.

• Gerontology Registered Nurse in Bedford, TX
• Providers in Bedford, TX by specialty
• Gerontology Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.