Active NPI
Chermelle Lynn Waller-Boone, RDH
- Dental Hygienist
- Madison, TN
National Provider Identifier
1437984036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH0000004103
- Practice address
- 117 Gallatin Pike N
Madison, TN 37115-3701 - Phone
- (615) 868-6177
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH0000004103 | TN | Primary |
Addresses
Primary practice location
117 Gallatin Pike N
Madison, TN 37115-3701
Mailing address
110 Fonnic Dr
Goodlettsville, TN 37072-3005
Phone (615) 566-4668
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH0000004103 | TN | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Dental PLLC | 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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Madison, TN
- NPI 1386209849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1437984036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 FONNIC DR",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370723005",
"telephone_number": "615-566-4668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 GALLATIN PIKE N",
"city": "MADISON",
"state": "TN",
"postal_code": "371153701",
"telephone_number": "615-868-6177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER-BOONE",
"first_name": "CHERMELLE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TN",
"license": "DH0000004103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.