RICHARD EDWIN WALLER M.D. NPI 1821001041

NPI Information

  • NPI: 1821001041
  • Provider Name: RICHARD EDWIN WALLER, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1024 MARTIN LUTHER KING DRIVE
    MARKS, MS
    ZIP 38646
  • Phone: (662) 326-3502

Map and Directions

Get Directions

NPI Details

Richard Edwin Waller, M.D. is a family medicine in Marks, MS with 52 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Richard Edwin Waller, M.D. NPI is 1821001041. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year:1974

The provider's business location address is:

1024 MARTIN LUTHER KING DRIVE
MARKS, MS
ZIP 38646-289
Phone: (662) 326-3502
Fax: (662) 326-2555

The NPI 1821001041 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Manual urinalysis test with examination using microscope, non-automated (HCPCS:81000)

The enumeration date for this NPI number is 8/15/2006 and was last updated on 3/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine07067MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100115098MEDICAIDMISSISSIPPI
2C47952MEDICARE UPINMISSISSIPPI
3080000562MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI