Fay Marshelle Waller, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71016908A Issued in IN

Practice address

5425 Rosslyn Ave
Indianapolis, IN 46220-3323

Phone

(615) 274-9767

Fax

(833) 450-4801

NPI assigned

Jun 28, 2025

Last updated

Mar 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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, 2024

Medicare assignment

May accept Medicare assignment

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

• Iris Medical Group

  • Primary Care Clinic/Center
  • Brentwood, TN
  • NPI 1851025902

  Family, IN

  Medicare reassignment NPD
• Woundology Mso LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1568278208
  NPD
• Iris Wound Care, PC

  • Clinic/Center
  • Brentwood, TN
  • NPI 1568273605
  NPD
• Spine Center of Fort Wayne

  • Chiropractor
  • Fort Wayne, IN
  • NPI 1417297839
  NPD (past)
• Together Homecare of Fort Wayne LLC

  dba Team Select Home Care

  • Home Health Agency
  • Fort Wayne, IN
  • NPI 1124566138
  NPD (past)

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1750270500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9019 OVERLOOK BLVD STE C1",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272736",
            "telephone_number": "615-274-9767",
            "fax_number": "833-450-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 ROSSLYN AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203323",
            "telephone_number": "615-274-9767",
            "fax_number": "833-450-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "FAY",
        "middle_name": "MARSHELLE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-28",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016908A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tresa C Wallace, WHNP
• Alysha Wallen
• Mark Wallen, RBT
• William Wallen, MD
• Bruce F Waller, MD
• Keiona L Waller, APRN, FNP-BC
• Kensie Waller, FNP
• Laura M Waller
• Barbara J Walling, FNP
• Guy R Walling, NP NURSE PRACTITIONE

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.