Jerri Ashley Waller, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01269989 Issued in VA

Practice address

825 Fairfax Ave
Suite 544
Norfolk, VA 23507-1914

Phone

(757) 446-7900

NPI assigned

Mar 22, 2016

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 VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Brody School of Medicine at East Carolina University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evms Academic Physicians and Surgeons Health Services FoundationGroup PAC ID 5698675510, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwaller222459@direct.rivhs.com

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.

• Evms Academic Physicians and Surgeons Health Services Foundation

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1003887118

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD

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

• Sentara Hospitals

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1386006286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 544",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "SUITE 544",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JERRI",
        "middle_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "01269989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF MEDCINE MEDICAL LICENSE",
            "identifier": "101269989",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin E. Wallace, PHYSICIAN ASSISTANT
• Taylor Sterling Wallace, M.D.
• Diane Marie Wallach, OD
• Daniel Waller
• Eva Jayne Waller, M.D.
• Timothy Bernard Walls, M.D.
• Bernardita Walsh, BS
• Deborah Ann Walsh, FNP-BC
• Derrick Walston
• Dajuan Walters

• Obstetrics & Gynecology Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.