WILLIAM C WALLER CCP
NPI 1417801002
in Richland, MS
About William C Waller Ccp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLIAM C WALLER CCP (NPI 1417801002) is an individual healthcare provider in Richland, Mississippi, licensed in Georgia (154) and active in the NPI registry since February 2026.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is William Waller's NPI number?
The NPI number for William Waller is 1417801002. It was assigned to this individual provider in the NPPES registry on February 23, 2026.
Where is William Waller located?
William Waller practices at 314 Southwind Dr, Richland, MS 39218. The listed phone number is (601) 502-4381.
When was this NPI record last updated?
The NPPES record for William Waller was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# William C Waller, CCP · NPI 1417801002
Healthcare provider in Richland, Mississippi. Individual provider, active in the CMS NPPES registry since February 23, 2026.
## Identity
- **NPI:** 1417801002 (Entity type: Individual)
- **Enumerated:** February 23, 2026
- **State license:** 154 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 314 SOUTHWIND DR, Richland, MS 39218-9215
- **Phone:** (601) 502-4381
## Record status
- **NPPES last updated:** February 23, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1417801002) · Data from the CMS NPPES public registry.