ADAM WALLER NP
NPI 1508476615
Nurse Practitioner in West Frankfort, IL

Q: What is Adam Waller's NPI number?

The NPI number for Adam Waller is 1508476615. It was assigned to this individual provider in the NPPES registry on August 4, 2020.

Q: What is Adam 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 Adam Waller was last updated on May 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 04, 2020PECOS EnrolledAccepts Medicare Assignment

75.73/100

CMS Quality Rating

502 W SAINT LOUIS ST STE 4, WEST FRANKFORT, IL 62896(618) 937-3400(618) 997-9324 Get Directions Write a Review

NPPES record last updated: May 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 23, 2022, Apr 11, 2022, Aug 4, 2020 (3 updates tracked since 2020).

On this page

About Adam Waller Np NPPES

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

ADAM WALLER NP (NPI 1508476615) is an individual nurse practitioner in West Frankfort, Illinois, licensed in Illinois (209021745) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1508476615

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameADAM WALLERCredential: NP

Location Address502 W SAINT LOUIS ST STE 4West Frankfort, IL 62896-1968

Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 937-3400 · Fax (618) 997-9324

Phone(618) 937-3400

Fax(618) 997-9324

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 4, 2020

Last NPPES UpdateMay 23, 20223 updates tracked since enumeration

NPPES CertifiedMay 23, 2022

✔ NPI 1508476615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209021745

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.

502 W SAINT LOUIS ST STE 4, West Frankfort, IL 62896

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Secondary Practice Locations 2

Location 12601 W Main StCarbondale, IL 62901-1031 · Phone (618) 549-5361 · Fax (618) 351-4878

Location 2405 Rushing DrHerrin, IL 62948-3730 · Phone (618) 993-3300 · Fax (618) 993-0262

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

Adam Waller Np 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 ID9931527512

PECOS Enrollment IDI20200914002215

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

305 services51 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

146 services45 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

34 services27 patients

Hospital Affiliations CMS Care Compare 3

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140164

Location405 W JacksonCarbondale, IL 62901 · Jackson County

Emergency services Birthing friendly

Franklin Hospital

Critical Access Hospitals · Benton, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141321

Location201 Bailey LaneBenton, IL 62812 · Franklin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62896 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.73/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

63.09

Promoting Interoperability

100

Improvement Activities

Cost

45.26

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$19.50 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$109.33 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers49 claims49 services$18.99 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers12 claims12 services$9.28 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

SOUTHERN ILLINOIS MEDICAL SERVICES, NFP

Clinic/Center (Rural Health)