Charles Waller, MD - Medicare General Practice in Benton, KY

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Charles Waller, MD is a medicare enrolled "General Practice" physician in Benton, Kentucky. His current practice location is 218 Bass Ln, Benton, Kentucky. You can reach out to his office (for appointments etc.) via phone at (270) 556-3239.

Charles Waller is licensed to practice in Kentucky (license number 29738) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1306841341.

Contact Information

Charles Waller, MD
218 Bass Ln,
Benton, KY 42025-5824
(270) 556-3239
(270) 354-5865

Map and Direction




Physician's Profile

Full NameCharles Waller
GenderMale
SpecialityGeneral Practice
Location218 Bass Ln, Benton, Kentucky
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1306841341
  • Provider Enumeration Date: 06/16/2005
  • Last Update Date: 02/01/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 0244212645
  • Enrollment ID: I20040601000835

Medical Identifiers

Medical identifiers for Charles Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1306841341NPI-NPPES
4047217MedicaidTN
64297385MedicaidKY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 29738 (Kentucky)Primary
207P00000XEmergency Medicine 29738 (Kentucky)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Waller allows following entities to bill medicare on his behalf.
Entity NameTrigg County Hospital, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538218680
PECOS PAC ID: 5193620805
Enrollment ID: O20031205000118
Entity NameSoutheastern Emergency Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356379382
PECOS PAC ID: 2466364997
Enrollment ID: O20050302000285
Entity NameApp Of Kentucky Ed, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497157341
PECOS PAC ID: 0749502862
Enrollment ID: O20141201000389
Entity NameHospital Medicine Services Of Tennessee Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528433802
PECOS PAC ID: 9234432881
Enrollment ID: O20160803001623

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Waller is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Charles Waller, MD
218 Bass Ln,
Benton, KY 42025-5824

Ph: (270) 556-3239		Charles Waller, MD
218 Bass Ln,
Benton, KY 42025-5824

Ph: (270) 556-3239

Reviews and Comments


General Practice Doctors in Benton, KY


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.