MR. RICHARD KEITH WALLER APRN
NPI 1215770516
Nurse Practitioner in Edgewood, KY

Q: What is Richard Waller's NPI number?

The NPI number for Richard Waller is 1215770516. It was assigned to this individual provider in the NPPES registry on June 14, 2024.

Q: What is Richard Waller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Waller was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 14, 2024PECOS EnrolledAccepts Medicare Assignment

1 MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017(859) 757-2927 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 15, 2025, Nov 7, 2025, Jun 14, 2024 (3 updates tracked since 2024).

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About Mr. Richard Keith Waller Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RICHARD KEITH WALLER APRN (NPI 1215770516) is an individual nurse practitioner in Edgewood, Kentucky, licensed in Kentucky (4047540) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and maintains a secondary practice location in Cincinnati.

NPPES Registry Identity

NPI1215770516

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMR. RICHARD KEITH WALLERCredential: APRN

Location Address1 MEDICAL VILLAGE DRIVEEdgewood, KY 41017-3403

Mailing Address1 Medical Village DriveEdgewood, KY 41017-3403 · (859) 757-2927 · Fax (859) 341-0203

Phone(859) 757-2927

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJune 14, 2024

Last NPPES UpdateDecember 15, 20253 updates tracked since enumeration

NPPES CertifiedDecember 15, 2025

✔ NPI 1215770516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in KY · 4047540

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 0036149 (OH)

1 MEDICAL VILLAGE DRIVE, Edgewood, KY 41017

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Secondary Practice Location 1

Location 111135 Montgomery RdCincinnati, OH 45249-2338 · Phone (513) 791-7572 · Fax (513) 791-8240

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Richard Keith Waller Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870033939

PECOS Enrollment IDI20240904003436, I20251202003196

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

Bethesda North

Acute Care Hospitals · Cincinnati, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360179

Location10500 Montgomery RoadCincinnati, OH 45242 · Hamilton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBORAH ELAINE BLISS ACNP

Nurse Practitioner (Acute Care)

1 MEDICAL VILLAGE DRIVE, ST. ELIZABETH HEALTHCARE
EDGEWOOD, KY 41017

Kenton County (859) 301-2000

DR. IAN CRAIG TALBOTT D.O.

Pathology (Anatomic Pathology & Clinical Pathology)