Makeba Waller

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

42313 Issued in TX

Practice address

5860 S Cooper St Ste 100
Arlington, TX 76017-5100

Phone

(817) 235-2235

NPI assigned

Feb 16, 2017

Last updated

Jun 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Ultrasound Imaging Concepts, LLC

  • Radiology Clinic/Center
  • Arlington, TX
  • NPI 1881122570
  NPD Authorized official

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1790224210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 S COOPER ST STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175100",
            "telephone_number": "817-235-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 S COOPER ST STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175100",
            "telephone_number": "817-235-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "MAKEBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "TX",
            "license": "42313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Lee Wallace, DDS
• Rene Wallace
• Sylvin Wallace, RBT
• Derhonda Waller
• Lynne Marie Waller
• Randell Wayne Walling, D.C.
• Jo Beth Walls
• Vicki Walls, LPC
• Amy Walsh
• Jonathan Martin Walsh, MD

• Sonography Radiologic Technologist in Arlington, TX
• Providers in Arlington, TX by specialty
• Sonography Radiologic Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.