Active NPI
Lauren Kathleen Waller, PT, DPT
- Physical Therapist
- Nashville, TN
National Provider Identifier
1649738436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11477
- Practice address
- 4825 Trousdale Dr Ste 216
Nashville, TN 37220-1307 - Phone
- (615) 781-1005
- Fax
- (615) 781-1009
- NPI assigned
- Mar 11, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11477 | TN | Primary |
Addresses
Primary practice location
4825 Trousdale Dr Ste 216
Nashville, TN 37220-1307
Mailing address
2817 W End Ave Ste 126-108
Nashville, TN 37203-1453
Phone (615) 557-8204
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11477 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627776000000",
"number": "1649738436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 W END AVE STE 126-108",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031453",
"telephone_number": "615-557-8204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 TROUSDALE DR STE 216",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372201307",
"telephone_number": "615-781-1005",
"fax_number": "615-781-1009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLER",
"first_name": "LAUREN",
"middle_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2021-08-01",
"certification_date": "2021-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "11477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.