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JOHN L WALLER CRNA
NPI 1427105980
Nurse Anesthetist, Certified Registered in Reidsville, NC

Active since January 05, 2007
618 S MAIN ST, REIDSVILLE, NC 27320(336) 951-4000 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About John L Waller Crna NPPES

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

JOHN L WALLER CRNA (NPI 1427105980) is an individual nurse anesthetist, certified registered in Reidsville, North Carolina, licensed in North Carolina (038610) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1427105980
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJOHN L WALLERCredential: CRNA
Location Address618 S MAIN STReidsville, NC 27320-5020
Mailing AddressPo Box 26580Greensboro, NC 27415-6580 · (336) 832-7786
Phone(336) 951-4000
Sole ProprietorNo
Enumeration DateJanuary 5, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1427105980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NC · 038610
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
618 S MAIN ST, Reidsville, NC 27320
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John L Waller Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show John Waller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wake Forest University Health Sciences
38 mi
Multi-Specialty
MEDICAL CENTER BLVD
Winston Salem, NC 27157
  • Reassigned Medicare billing, North Carolina enrollment
  • 3,003 clinicians in this Medicare group
NPI 1003803032 (336) 716-2255

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. AMELIA YARBROUGH M.A., CF-SLP
Speech-Language Pathologist
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-6090
KAREN E DANIEL CRNA
Nurse Anesthetist, Certified Registered
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-4000
MR. BRIAN AVERY SPIKER COTA/L
Occupational Therapy Assistant
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-6090
SCOTESIA Y DUNLAP
Physician Assistant
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-4823
GREENSBORO PATHOLOGY, LLC
Pathology (Anatomic Pathology & Clinical Pathology)
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 387-2500
MRS. BRITTANY MANNING STRADER PA-C
Physician Assistant
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 938-0800
NORTH STAR PATHOLOGY PLLC
Pathology (Anatomic Pathology & Clinical Pathology)
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-4551
TERESA SUSAN YATES CRNA
Registered Nurse
618 S MAIN ST
REIDSVILLE, NC 27320
Rockingham County (336) 951-4000

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 John Waller's NPI number?

The NPI number for John Waller is 1427105980. It was assigned to this individual provider in the NPPES registry on January 5, 2007.

Where is John Waller located?

John Waller practices at 618 S Main St, Reidsville, NC 27320. The listed phone number is (336) 951-4000.

What is John Waller's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is John Waller enrolled in Medicare?

Yes. John Waller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Waller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Waller reassigns Medicare benefits to Wake Forest University Health Sciences (Winston Salem, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Waller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Waller accept?

Health plans from Oscar Health Plan of North Carolina, Inc list John Waller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Waller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.