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Active NPI 1508476615 Individual Practitioner Male Practitioner

Adam Waller , NP

Nurse Practitioner • West Frankfort, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Adam Waller, NP is a certified Nurse Practitioner practicing in West Frankfort, IL. With approximately 6 years of clinical experience since completing medical education in 2020, Adam Waller delivers high-quality medical care to the local community at 502 W SAINT LOUIS ST STE 4.

Adam Waller maintains professional affiliations with Southern Illinois Medical Services Nfp, Logan Primary Care Service Corp. and accepts Medicare assignment.

Frequently performed procedures and clinical services include residence visit for established patient with moderate level of medical decision making, per day, if using time, at least, residence visit for established patient with low level of medical decision making, per day, if using time, at least, subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

502 W Saint Louis St Ste 4

West Frankfort, IL 628961968

Telephone 6189373400
Fax 6189979324
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in West Frankfort, IL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -8.8 yrs vs City Avg
City Avg: 14.8 Yrs
State Avg: 10.4 Yrs
Regional Practice Density
4 Specialists

Practicing in West Frankfort, IL (4929 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
48.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Waller (6 Years) 6 Yrs
West Frankfort Specialty Average (14.8 Years) 14.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes
305 51 $195.00 $103.87
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes
146 45 $130.00 $62.29
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
34 27 $171.00 $87.69

Medical Specialties & State Licenses

CMS Verified: 2022-05-23
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 209021745

(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.

Hospital & Practice Group Affiliations

Southern Illinois Medical Services Nfp

502 W Saint Louis St, West Frankfort, IL 628961968

Phone: 6189373400

Logan Primary Care Service Corp.

405 Rushing Dr, Herrin, IL 629483730

Secondary Practice Locations

2601 W Main St

Carbondale, IL 629011031

Phone: 6185495361

405 Rushing Dr

Herrin, IL 629483730

Phone: 6189933300

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Travis Seddon , NP-C

Nurse Practitioner

NPI 1265103006

Nurse Practitioner (Certified)

Christopher Shadowens , PA-C

Physician Assistant - Medical

NPI 1326152356

Physician Assistant (Certified)

Janalyn Elwood , NP

Nurse Practitioner

NPI 1346952728

Nurse Practitioner

David Mason , PA-C

Physician Assistant

NPI 1649210766

Physician Assistant (Certified)

Moya Cook , FNP

Nurse Practitioner - Family

NPI 1760610729

Family Nurse Practitioner

Amy Stacey , PA

Physician Assistant

NPI 1962041830

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2022

Nurse Practitioner (License #209021745 in IL)

📍
Updated Practice Location April 11, 2022

Registered at 502 W SAINT LOUIS ST STE 4, WEST FRANKFORT, IL 628961968 (Tel: 6189373400)

📍
Updated Business Mailing Address April 11, 2022

Registered at PO BOX 3988, CARBONDALE, IL 629023988 (Tel: 6189373400)

👤
Provider Name / Credentials Updated April 11, 2022

Recorded as ADAM WALLER, NP

NPI Profile Active August 04, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 04, 2020

Registered at 408 LINCOLN DR STE B, HERRIN, IL 629483790 (Tel: 6183514980)

📍
Updated Business Mailing Address August 04, 2020

Registered at 1600 BRANDY LN, CARTERVILLE, IL 629185124 (Tel: 6185288011)

👤
Provider Name / Credentials Updated August 04, 2020

Recorded as ADAM WALLER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2020

Nurse Practitioner (License #209.021745 in IL)

🟢
Initial NPI Registration & Enumeration August 04, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508476615
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 04, 2020
Last Update: May 23, 2022
Sole Proprietor: Yes

Mailing Address

Po Box 3988

Carbondale, IL 629023988

Phone: 6189373400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.