MR. ROBERT WALLER (NPI# 1831494525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831494525 |
| Entity Type | Individual |
| Full Name | MR. ROBERT WALLER |
| Credential | MS, ATC, LAT, NASM |
| Practice Address |
10651 Wilshire Ave Ne Albuquerque NM 87122-3160 |
| Practice Telephone | 3077662323 |
| Mailing Telephone | 3077662323 |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
590 | NM | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699267872 | Robert Andrew Waller Jr. | Student in an Organized Health Care Education/Training Program | 500 University Dr, Hershey, PA 17033-2360 | 2018-06-04 |
| 1174014625 | Robert Scott Waller | Psychologist | 1276 N Clybourn Ave, Chicago, IL 60610 | 2018-05-21 |
| 1760543508 | Robert Ray Waller | Psychologist | 2500 S Broadway, Building 200, Edmond, OK 73013-4038 | 2006-12-13 |
| 1326097809 | Robert C Waller | Emergency Medicine | 75 Sheldon Blvd Se, Grand Rapids, MI 49503-4224 | 2006-05-10 |
| Street Address |
10651 WILSHIRE AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87122-3160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700426988 | Sophia Khalil | Student in an Organized Health Care Education/Training Program | 11128 Jordan Avenue Northeast, Albuquerque, NM 87122 | 2020-01-15 |
| 1457716664 | Raymond Martinez | Pharmacist | 7847 Tramway Ne, Albuquerque, NM 87122 | 2015-12-15 |
| 1891181913 | Paul Wright | Occupational Therapist | 30 Canocito Drive Ne, Albuquerque, NM 87122 | 2015-04-15 |
| 1356736615 | Tracy Pfeifer | Day Training/Habilitation Specialist | 8920 Holly Avenue Ne, Suite 102b, Albuquerque, NM 87122 | 2015-04-03 |
| 1346595071 | Jonathan Harper Kelley | Dentist | 9015 Paseo Del Norte Ne Ste A, Albuquerque, NM 87122 | 2012-07-18 |
| 1639444946 | Charlsey Leigh Mcdonald | Physical Therapist | 7920 Carmel Ave. Ne, Suite 2, Albuquerque, NM 87122 | 2012-03-20 |
| 1235462250 | Pamela Kay Limke | Pharmacist | 12112 Summer Wind Pl Ne, Albuquerque, NM 87122 | 2009-09-09 |
| 1437395332 | High Desert Pedicatrics PC | Pediatrics | 8650 Almeda Boulevard, Ne, Unit 101 E, Albuquerque, NM 87122 | 2008-12-23 |
| 1952427510 | Thomas Harry Heflin | Dentist | 8000 Carmel Ave, Albuquerque, NM 87122 | 2007-03-22 |
| 1497885032 | Thomas H Heflin Dds Pa | Dentist | 8000 Carmel Avenue Ne, Albuquerque, NM 87122 | 2007-03-06 |
| Find all providers in zip 87122 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447867403 | Hayley Lucero | Specialist/Technologist | 2300 Diamond Mesa Trl Sw Apt 9702, Albuquerque, NM 87121-3723 | 2020-09-24 |
| 1518504885 | Douglas Richard Spence | Specialist/Technologist | 2920 Leopoldo Rd Nw, Albuquerque, NM 87104-2728 | 2019-12-05 |
| 1972155349 | Daisuke Shibata | Specialist/Technologist | 1 University of New Mexico # 42610, Albuquerque, NM 87131-0001 | 2019-07-15 |
| 1922562685 | Keliana De Neef | Specialist/Technologist | 1155 University Blvd Se, Albuquerque, NM 87106-4320 | 2019-01-28 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1942782453 | Sean Yun Chu | Specialist/Technologist | 1531 Barbaro Dr Se, Albuquerque, NM 87123-2690 | 2018-08-30 |
| 1487161550 | Jensen D Bryan | Specialist/Technologist | 1741 Bellamah Ave Nw Apt 4308, Albuquerque, NM 87104-2263 | 2018-01-10 |
| 1609382613 | Miranda Hammer | Specialist/Technologist | 10619 Antler Tool Rd Sw, Albuquerque, NM 87121-5433 | 2017-12-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1578019295 | Eryka Paredes | Specialist/Technologist | 9528 Granite Ridge Dr. Nw, Albuquerque, NM 87114-3774 | 2016-09-01 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87122 |
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| 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.