Mrs Kimberly L Waller, PA-C in Grants Pass, OR - Medicare Physician Assistant

Mrs Kimberly L Waller, PA-C is a medicare enrolled "Physician Assistant" in Grants Pass, Oregon. She graduated from nursing school in 1997 and has 28 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Siskiyou Community Health Center Inc and her current practice location is 1701 Nw Hawthorne Ave, Grants Pass, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 471-3455.

Mrs Kimberly L Waller is licensed to practice in Oregon (license number PA01142) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1093782914.

Contact Information

	Mrs Kimberly L Waller, PA-C
	1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051
	(541) 471-3455
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kimberly L Waller
Gender	Female
Speciality	Physician Assistant
Experience	28 Years
Location	1701 Nw Hawthorne Ave, Grants Pass, Oregon
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Kimberly L Waller graduated from nursing school in 1997

NPI Data:

NPI Number: 1093782914
Provider Enumeration Date: 03/01/2006
Last Update Date: 10/28/2019

Medicare PECOS Information:

PECOS PAC ID: 0749175255
Enrollment ID: I20061101000505

Medical Identifiers

Medical identifiers for Mrs Kimberly L Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093782914	NPI	-	NPPES
100503581	Medicaid	NV
100503226	Medicaid	NV

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	PA842 (Nevada)	Secondary
363A00000X	Physician Assistant	PA01142 (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Asante Three Rivers Medical Center	Grants pass, OR	Hospital
Sutter Coast Hospital	Crescent city, CA	Hospital
Asante Rogue Regional Medical Center	Medford, OR	Hospital
Mercy Medical Center	Roseburg, OR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Siskiyou Community Health Center Inc	6305747288	28

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. Mrs Kimberly L 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 Address	Practice Location Address
Mrs Kimberly L Waller, PA-C 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 Ph: (541) 471-3455	Mrs Kimberly L Waller, PA-C 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 Ph: (541) 471-3455

Reviews and Comments

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Mrs Kimberly L Waller, PA-C - Medicare Physician Assistant in Grants Pass, OR