Angela Waller, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

145635 Issued in AK

Practice address

760 Holton Whitehall Rd
Whitehall, MI 49461-9559

Phone

(231) 206-0703

NPI assigned

May 16, 2013

Last updated

May 8, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI, AK2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1013089820

  Family

  Medicare reassignment NPD
• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041
  Medicare reassignment NPD
• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • Urgent Care Clinic/Center
  • Portage, MI
  • NPI 1417130154
  NPD
• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
  • NPI 1518753441
  NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD
• Emergency Health Partners Muskegon

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1235179029
  NPD (past)

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1295171270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 HOLTON WHITEHALL RD",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494619559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 HOLTON WHITEHALL RD",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494619559",
            "telephone_number": "231-206-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANGELA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "145635",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704225835",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey L. Uganski, RPH
• Nancy Dale Vanderroest, LLPC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP (Walmart Vision Center 30-3458)
• Walgreen Co (Walgreens # 11417)
• Lindsay Anne Ware
• Karen Kay Welter
• White Lake Assisted Living
• White Lake Chiropractic Centre Inc
• Whitehall SNF, LLC (Illuminate HC Whitehall)

• Family Nurse Practitioner in Whitehall, MI
• Providers in Whitehall, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.