STEPHEN C WALLER (NPI# 1285678680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285678680 |
| Entity Type | Individual |
| Full Name | STEPHEN C WALLER |
| Credential | PA |
| Practice Address |
6925 Shallowford Rd Suite 206 Chattanooga TN 37421-1787 |
| Practice Telephone | 4238940432 |
| Practice Fax Number | 4238940475 |
| Mailing Telephone | 4238940432 |
| Mailing Fax Number | 4238940475 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA0000000545 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | NPI | 1285678680 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891727269 | Stephen B Waller | Chiropractor | 1121 Kinwest Pkwy, Suite 100, Irving, TX 75063-3135 | 2006-07-07 |
| 1477699205 | Stephen Frank Waller | Specialist | 333 N Rivershire Dr, Suite 265, Conroe, TX 77304-0001 | 2007-01-29 |
| 1043313968 | Stephen C Waller | Internal Medicine | 3901 Rainbow Boulevard, 6067 Delp, Mail Stop 1028, Kansas City, KS 66160 | 2006-09-06 |
| 1629057609 | Stephen Glenn Waller | Ophthalmology | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2006-01-10 |
| Street Address |
6925 SHALLOWFORD RD SUITE 206 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-1787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730382391 | Sport Med Physical Therapy | Physical Therapist | 6925 Shallowford Rd, Suite 207, Chattanooga, TN 37421-1787 | 2007-06-08 |
| 1790831113 | Medtech Enterprises | Durable Medical Equipment & Medical Supplies | 6925 Shallowford Rd, 207, Chattanooga, TN 37421-1787 | 2007-01-26 |
| 1659459139 | Geoffrey Deane Peterson | Nurse Practitioner | 6925 Shallowford Rd, Apt 206, Chattanooga, TN 37421-1787 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1174008759 | Melissa Ann Hart | Physician Assistant | 2518 Waterhaven Dr, Chattanooga, TN 37406-1143 | 2018-09-28 |
| 1124510193 | Carter Alexis Pieper | Physician Assistant | 961 Spring Creek Rd Ste 100, Chattanooga, TN 37412-3959 | 2018-06-05 |
| 1306352844 | Anne Marie Medved | Physician Assistant | 1185 Mountain Creek Rd Apt 1410, Chattanooga, TN 37405-1657 | 2017-12-20 |
| 1225577190 | Stephanie Ford Mcallister | Physician Assistant | 7446 Shallowford Rd Ste 104, Chattanooga, TN 37421-8817 | 2017-02-13 |
| 1386182269 | Laura Ann Hixon | Physician Assistant | 901 Riverfront Pkwy Ste 300, Chattanooga, TN 37402-2198 | 2017-02-10 |
| 1407203409 | Hannah James | Physician Assistant | 5616 Brainerd Rd Ste 208, Chattanooga, TN 37411-5376 | 2016-05-19 |
| 1639556970 | Amanda Carleo | Physician Assistant | 6035 Shallowford Rd Ste 101, Chattanooga, TN 37421-1688 | 2015-05-06 |
| 1003200312 | Brittany Cannon | Physician Assistant | 979 E 3rd St Ste G, Chattanooga, TN 37403-2136 | 2015-03-25 |
| 1619368727 | Brittney Viar | Physician Assistant | 2358 Lifestyle Way, Suite 212, Chattanooga, TN 37421-2291 | 2015-02-11 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on STEPHEN C WALLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.