Andrew Waller (NPI# 1053334219, PAC ID# 8628147550) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ADDICTION MEDICINE.
| Nation Provider ID (NPI) | 1053334219 |
| PAC ID by PECOS | 8628147550 |
| Professional Enrollment ID | I20191002001323 |
| Full Name | Andrew Waller |
| Organization Legal Name | REVIDA RECOVERY CENTERS PC |
| Address |
300 Valley St Ne Abingdon VA 24210-2912 |
| Phone Number | 2762068197 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF OHIO |
| Graduation Year | 1986 |
| Primary Specialty | ADDICTION MEDICINE |
| Group Practice PAC ID | 1153657473 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 300 Valley St Ne, Abingdon, VA 24210-2912 | 2762068197 | REVIDA RECOVERY CENTERS PC |
| Organization Legal Name | REVIDA RECOVERY CENTERS PC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Neal Ray Sanders | Pediatric Medicine | Revida Recovery Centers PC | 198 Ross Carter Blvd, Duffield, VA 24244-5117 |
| Marianne E Filka | Addiction Medicine | Revida Recovery Centers PC | 3114 Browns Mill Rd, Johnson City, TN 37604-1417 |
| Craig M Haire | Internal Medicine | Revida Recovery Centers PC | 1369 W Andrew Johnson Hwy, Morristown, TN 37814-3725 |
| Guy D Clark | Emergency Medicine | Revida Recovery Centers PC | 2001 Highland Ave, Knoxville, TN 37916-1217 |
| Pamela Beaver Wells | Nurse Practitioner | Revida Recovery Centers PC | 300 Valley St Ne, Abingdon, VA 24210-2912 |
| Hannah Ellen Ratliff | Family Medicine | Revida Recovery Centers PC | 198 Ross Carter Blvd, Duffield, VA 24244-5117 |
| Kelly C Cooper | Preventative Medicine | Revida Recovery Centers PC | 2001 Highland Ave, Knoxville, TN 37916-1217 |
| Jennifer C Wisdom-schepers | Psychiatry | Revida Recovery Centers PC | 3114 Browns Mill Rd, Johnson City, TN 37604-1417 |
| Michael P Kauzlarich | Family Medicine | Revida Recovery Centers PC | 3114 Browns Mill Rd, Johnson City, TN 37604-1417 |
| Melanie L Skeen | Addiction Medicine | Revida Recovery Centers PC | 300 Valley St Ne, Abingdon, VA 24210-2912 |
| Street Address |
300 VALLEY ST NE |
| City | ABINGDON |
| State | VA |
| Zip | 24210-2912 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pamela Beaver Wells | Nurse Practitioner | Revida Recovery Centers PC | 300 Valley St Ne, Abingdon, VA 24210-2912 |
| Melanie L Skeen | Addiction Medicine | Revida Recovery Centers PC | 300 Valley St Ne, Abingdon, VA 24210-2912 |
| Adrian Scott Thacker | Nurse Practitioner | Revida Recovery Centers PC | 300 Valley St Ne, Abingdon, VA 24210-2912 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Donald M Cobb | Diagnostic Radiology | Abingdon Radiology Services Ltd | Hospital Dr, Abingdon, VA 24210 |
| Ernest Noel Henry | Nephrology | 323 Falls Plaza Dr, Abingdon, VA 24210 | |
| Joe G Blankenship | Diagnostic Radiology | Abingdon Radiology Services Ltd | Hospital Dr, Abingdon, VA 24210 |
| Casey Dillon Mcreynolds | Diagnostic Radiology | Abingdon Radiology Services Ltd | Hospital Dr, Abingdon, VA 24210 |
| John Richard Mullens Iii | Diagnostic Radiology | Abingdon Radiology Services Ltd | Hospital Dr, Abingdon, VA 24210 |
| Jason J Jordan | Clinical Social Worker | Family Preservation Services Inc | 661 E Main St, Abingdon, VA 24210-2339 |
| Cindy R Vaughn | Nurse Practitioner | Family Preservation Services Inc | 661 E Main St, Abingdon, VA 24210-2339 |
| Sally Barca | Clinical Social Worker | Family Preservation Services Inc | 661 E Main St, Abingdon, VA 24210-2339 |
| Russell H Williams | Clinical Social Worker | Family Preservation Services Inc | 661 E Main St, Abingdon, VA 24210-2339 |
| Robert A Boothe Ii | Chiropractic | 108 Reedy Creek Rd, Abingdon, VA 24210-2436 | |
| Find all physicians in zip 24210 | |||
| City | ABINGDON |
| Zip Code | 24210 |
| Specialty | ADDICTION MEDICINE |
| City + Specialty | ABINGDON + ADDICTION MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.