Pris,PLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101055485 Issued in VA

Legal business name

PRIS,PLC

Practice address

2600 Memorial Ave
Suite 201B
Lynchburg, VA 24501-2662

Phone

(434) 528-0896

Fax

(434) 528-0898

NPI assigned

Jun 16, 2009

Last updated

Jan 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brenda Sue Waller, MDNPI 1093794133

Title

Ceo

Phone

(434) 528-0896

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brenda Waller , MD Other name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brenda Sue Waller, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Lynchburg, VA
  • NPI 1093794133
  Authorized official Same address or phone
• Evelyn Maria Cason, NP-C

  • Acute Care Nurse Practitioner
  • Petersburg, VA
  • NPI 1235458233
  NPD (past)
• Lloyd Henry Walker, PA

  • Medical Physician Assistant
  • Lynchburg, VA
  • NPI 1316222755
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1891922928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MEMORIAL AVE",
            "address_2": "SUITE 201B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012662",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MEMORIAL AVE",
            "address_2": "SUITE 201B",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012662",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIS,PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-528-0896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101055485",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101055485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010045100",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brenda Waller , MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patrick Regan Priest, LPTA
• Kayla Prillaman
• Theshay Prince
• Kelley Prinzbach
• Pris, PLC
• Matthew Shawn Pritchett
• Pro Careers Inc./LCD
• Pro Careers Inc./LPC
• Pro Careers Inc./LRC
• Samuel W Procopio, DPT, PT

• Physical Medicine & Rehabilitation Physician in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.