Jason Waller, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

16730 Issued in MS

Practice address

2301 S Lamar Blvd
Oxford, MS 38655-5373

Phone

(800) 291-4020

Fax

(919) 419-7247

NPI assigned

May 19, 2006

Sex

Male

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

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

R Franklin University of Med & Sci/Chicago Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Emergency Services Inc.Group PAC ID 5799697272, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.46 of 100Reported as group

Quality

71.9

Improvement activities

40

Cost

87.09

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwmjwalle@yourcarecommunity.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Baptist Memorial Hospital North Mississippi, Inc

  • General Acute Care Hospital
  • Oxford, MS
  • NPI 1053375576

  Corporate Director

  CMS ownership
• Baptist Memorial Hospital North Mississippi, Inc

  • Rehabilitation Hospital Unit
  • Oxford, MS
  • NPI 1225125859

  Corporate Officer

  CMS ownership

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.

• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  Medicare reassignment Care Compare group NPD
• Dobbs Emergency Group, LLC

  • Emergency Medicine Physician
  • Calhoun City, MS
  • NPI 1205499639
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital North Mississippi, Inc

  • General Acute Care Hospital
  • Oxford, MS
  • NPI 1053375576
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1952355653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 SHANNON RD",
            "address_2": "SUITE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076322",
            "telephone_number": "800-291-4020",
            "fax_number": "919-419-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555373",
            "telephone_number": "800-291-4020",
            "fax_number": "919-419-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JASON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "16730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Keith Wall, MD
• April Reed Wallace, CCC-SLP
• Ashlee Wallace, RN
• David R Wallace, PT
• Walter Moore Wallace, L.C.S.W.
• Waller'S Discount Drugs, Inc.
• Ryan Shelton Wally, O.D.
• Joshua M Walston
• Marc E Walters, PCMHT
• Shelby R Walters, MD

• Emergency Medicine Physician in Oxford, MS
• Providers in Oxford, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.