BENJAMIN R WALLER III (NPI# 1013974062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013974062 |
| Entity Type | Individual |
| Full Name | BENJAMIN R WALLER III |
| Credential | MD |
| Practice Address |
51 N Dunlap St Fl 2 Memphis TN 38105 |
| Mailing Address |
848 Adams Ave Memphis TN 38103-2816 |
| Practice Telephone | 9012877337 |
| Practice Fax Number | 9012874646 |
| Mailing Telephone | 9012875594 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
19846 | TN | Allopathic & Osteopathic Physicians |
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
19846 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3086106 | 05 |
| Street Address |
51 N DUNLAP ST FL 2 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922076272 | Christopher Knott-craig | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 51 N Dunlap St Fl 2, Memphis, TN 38105-4625 | 2006-03-11 |
| 1093190365 | Ryan E Stephens | Nurse Practitioner | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2015-07-28 |
| 1477893121 | Maria Del Pilar Anton Martin | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2013-02-17 |
| 1598022675 | Kaitlin Anne Ryan | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2012-04-13 |
| 1891051348 | Vasu D. Gooty | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105-4625 | 2012-04-10 |
| 1295018216 | Leah Marie Apalodimas | Nurse Practitioner | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2011-09-26 |
| 1346536042 | Hitesh Agrawal | Internal Medicine | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2011-06-22 |
| 1912299967 | Hugo Ruben Martinez | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105-4625 | 2011-05-10 |
| 1669764106 | Gary S Beasley | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2011-05-03 |
| 1518261171 | Jason Frederick Goldberg | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2010-12-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447887435 | Leeanne Chittom Mcdonald | Dietitian, Registered | Ulps Surgery, 2nd Floor, 50 N. Dunlap, Memphis, TN 38105 | 2020-03-27 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1720436710 | Angela Marie Pratt | Nurse Practitioner | 262 Danny Thomas Blvd, Memphis, TN 38105 | 2016-05-31 |
| 1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
| 1467864173 | Nicole Mary Alberts | Psychologist | 262 Danny Thomas Place, Mail Stop 740, Department of Psychology, St Jude Children's Research H, Memphis, TN 38105 | 2014-05-29 |
| 1689004160 | Virginia Carney | Dietitian, Registered | 262 Danny Thomas Place - Mail Stop 732, Memphis, TN 38105 | 2013-11-19 |
| 1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
| 1457622235 | Healthy Indigent Populations Inc. | Exclusive Provider Organization | 1066 Delmar, Memphis, TN 38105 | 2012-01-25 |
| 1285953265 | Nicholas Steve Phillips | Student in an Organized Health Care Education/Training Program | 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105 | 2010-05-31 |
| 1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
| Find all providers in zip 38105 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588172464 | Cardiac Cin of West Tennessee LLC | Internal Medicine | 5865 Ridgeway Center Pkwy Ste 300c, Memphis, TN 38120-4032 | 2018-01-13 |
| 1922520873 | Telemedico Physicians Professional Corporation | Internal Medicine | 5490 Shady Grove Ter, Memphis, TN 38120-2414 | 2017-07-12 |
| 1922003037 | Joseph Seth Weinstein | Internal Medicine | 4901 Raleigh Common Drive, Suite 100, Memphis, TN 38128 | 2005-06-15 |
| 1932495637 | Saint Francis Cardiology Associates LLC | Internal Medicine | 6005 Park Ave, Ste. 500b, Memphis, TN 38119-5215 | 2011-06-22 |
| 1346536042 | Hitesh Agrawal | Internal Medicine | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2011-06-22 |
| 1255564712 | Family Heart Center | Internal Medicine | 6019 Walnut Grove Rd, Memphis, TN 38120-2113 | 2009-09-01 |
| 1821121955 | Muhammad Janjua | Internal Medicine | 2996 Kate Bond Rd Ste 105, Memphis, TN 38133-4062 | 2007-03-14 |
| 1114098043 | David C Wolford | Internal Medicine | 8060 Wolf River Blvd, Memphis, TN 38138-1727 | 2006-11-13 |
| 1003991902 | Larry B Spiotta | Internal Medicine | 8060 Wolf River Blvd, Memphis, TN 38138-1727 | 2006-10-26 |
| 1760594238 | Nadish Garg | Internal Medicine | 1211 Union Ave Ste 965, Memphis, TN 38104 | 2006-08-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.