Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306931738 Individual Practitioner Female Practitioner

Dr. Angelique Gloster Waller , MD

Pediatrics • Cincinnati, OH

Professional Overview & Biography Verified Profile Summary

Dr. Angelique Waller, MD is a registered healthcare professional specializing in Pediatrics in Cincinnati, OH. Practice services are available at 8250 KENWOOD CROSSING WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8250 Kenwood Crossing Way
#205

Cincinnati, OH 45236

Telephone 5139488444
Fax 5139480756
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Cincinnati, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 20.0 Yrs
Regional Practice Density
538 Specialists

Practicing in Cincinnati, OH (3057 Statewide)

Telehealth Adoption Rate
0.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-16
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OH 35-067334

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0108387 (OH)

Practice Associates & Co-Workers

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

6 Associated Practitioners
Lindsi Meek , APN

Nurse Practitioner - Pediatrics

NPI 1023332871

Advanced Practice Nurse

NPI 1083904155

Doctor of Medicine (M.D.)

NPI 1407381528

Licensed Professional Clinical Counselor

NPI 1467542977

Doctor of Medicine (M.D.)

Kathleen Clifton , MSN, FNP-BC

Nurse Practitioner - Family

NPI 1730547571

Master of Science in Nursing, Family Nurse Practitioner (Board Certified)

NPI 1932786209

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Business Mailing Address October 16, 2024

Registered at 12061 SHERATON LN, CINCINNATI, OH 452461611 (Tel: 5133366700)

👤
Provider Name / Credentials Updated October 16, 2024

Recorded as ANGELIQUE WALLER, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 16, 2024

Pediatrics (License #35-067334 in OH)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 8250 KENWOOD CROSSING WAY, #205, CINCINNATI, OH 45236 (Tel: 5139488444)

📍
Updated Business Mailing Address July 08, 2007

Registered at 8335 KUGLER MEADOWS COURT, CINCINNATI, OH 45236 (Tel: 5132716855)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as ANGELIQUE GLOSTER, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #67334 in OH)

🟢
Initial NPI Registration & Enumeration October 03, 2006

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: 1306931738
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2006
Last Update: October 16, 2024
Sole Proprietor: No

Mailing Address

12061 Sheraton Ln

Cincinnati, OH 452461611

Phone: 5133366700

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.