Keiona L Waller, APRN, FNP-BC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

71014575A Issued in IN

Practice address

8805 N Meridian St
Indianapolis, IN 46260-2760

Phone

(317) 706-7246

NPI assigned

Nov 3, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shadeland Anesthesia and Pain Associates IncGroup PAC ID 2769468990, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Shadeland Anesthesia & Pain Associates Inc.

  dba Center for Pain Management

  • Interventional Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1477589000
  Medicare reassignment Care Compare group NPD
• Peak Health Chiropractic, P.C.

  dba Danville Chiropracitc

  • Chiropractor
  • Danville, IN
  • NPI 1821266255
  NPD
• Shadeland Anesthesia & Pain Associates Inc.

  dba Center for Pain Management

  • Durable Medical Equipment & Medical Supplies
  • Brownsburg, IN
  • NPI 1376429555

  Interventional Pain Medicine

  NPD

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1366215071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29943 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "317-706-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602760",
            "telephone_number": "317-706-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KEIONA",
        "middle_name": "L",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014575A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "71014575A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300100193",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alysha Wallen
• Mark Wallen, RBT
• William Wallen, MD
• Bruce F Waller, MD
• Fay Marshelle Waller, FNP-BC
• Kensie Waller, FNP
• Laura M Waller
• Barbara J Walling, FNP
• Guy R Walling, NP NURSE PRACTITIONE
• Martina Lynn Walling, PHARMD

• Interventional Pain Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Interventional Pain Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.