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KACI WALLER C-AA
NPI 1972219442
Anesthesiologist Assistant in Marietta, GA

Active since January 27, 2023Accepts Medicare Assignment
2637 ARBOR GLEN PL, MARIETTA, GA 30066(229) 589-7427 Get Directions Write a Review

NPPES record last updated: January 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kaci Waller C-aa NPPES

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

KACI WALLER C-AA (NPI 1972219442) is an individual anesthesiologist assistant in Marietta, Georgia and active in the NPI registry since January 2023. She is affiliated with Colquitt Regional Medical Center and is a graduate of Other (2022).

NPPES Registry Identity

NPI1972219442
Entity TypeIndividualFemale
Primary Taxonomy367H00000X
Provider Legal NameKACI WALLERCredential: C-AA
Location Address2637 ARBOR GLEN PLMarietta, GA 30066-4274
Mailing Address2637 Arbor Glen PlMarietta, GA 30066-4274
Phone(229) 589-7427
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 27, 2023
NPPES CertifiedJanuary 26, 2023
✔ NPI 1972219442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
2637 ARBOR GLEN PL, Marietta, GA 30066
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kaci Waller C-aa 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 ID244698801
PECOS Enrollment IDI20230614002707

Medicare Billing Reassignment

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

Ams Southeast LLC
295 mi
Anesthesiology
28 N PALAFOX ST
Pensacola, FL 32502
  • Reassigned Medicare billing, Georgia enrollment
  • 191 clinicians in this Medicare group
NPI 1487107157 (866) 653-2540

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

Hospital Affiliations CMS Care Compare

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

Colquitt Regional Medical Center

Acute Care Hospitals · Moultrie, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110105
Location3131 South Main StreetMoultrie, GA 31768 · Colquitt County
Emergency services Birthing friendly

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 Kaci Waller's NPI number?

The NPI number for Kaci Waller is 1972219442. It was assigned to this individual provider in the NPPES registry on January 27, 2023.

Where is Kaci Waller located?

Kaci Waller practices at 2637 Arbor Glen Pl, Marietta, GA 30066. The listed phone number is (229) 589-7427.

What is Kaci Waller's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Kaci Waller enrolled in Medicare?

Yes. Kaci Waller is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kaci Waller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaci Waller reassigns Medicare benefits to Ams Southeast LLC (Pensacola, FL). 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 Kaci Waller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kaci Waller affiliated with any hospitals?

According to CMS data, Kaci Waller is affiliated with Colquitt Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Kaci Waller was last updated on January 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.