Mrs Holli Dezaun Waller, DO in Blacksburg, VA

Mrs Holli Dezaun Waller, DO is a medicare enrolled "Family Medicine" physician in Blacksburg, Virginia. She went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2010 and has 14 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Premier Provider Health Pa and her current practice location is 3700 South Main Street, Blacksburg, Virginia. You can reach out to her office (for appointments etc.) via phone at (540) 953-5445.

Mrs Holli Dezaun Waller is licensed to practice in Virginia (license number 0116022785) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1053622167.

Contact Information

	Mrs Holli Dezaun Waller, DO
	3700 South Main Street, Blacksburg, VA 24060
	(540) 953-5445
	(540) 953-5453

Map and Direction

Physician's Profile

Full Name	Mrs Holli Dezaun Waller
Gender	Female
Speciality	Family Practice
Experience	14 Years
Location	3700 South Main Street, Blacksburg, Virginia
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Holli Dezaun Waller attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2010

NPI Data:

NPI Number: 1053622167
Provider Enumeration Date: 06/24/2010
Last Update Date: 06/24/2010

Medicare PECOS Information:

PECOS PAC ID: 6800043977
Enrollment ID: I20140327000229

Medical Identifiers

Medical identifiers for Mrs Holli Dezaun Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053622167	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	0116022785 (Virginia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Hca Houston Healthcare Tomball	Tomball, TX	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Premier Provider Health Pa	2264531276	21

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Holli Dezaun Waller allows following entities to bill medicare on her behalf.

Entity Name	Regional Employee Assistance Program Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649232984 PECOS PAC ID: 1557260064 Enrollment ID: O20040612000731

Entity Name	Premier Provider Health Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013397066 PECOS PAC ID: 2264531276 Enrollment ID: O20070615000236

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Holli Dezaun Waller is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Holli Dezaun Waller, DO 6326 Stonewood Pointe Ln., Houston, TX 77066 Ph: (281) 300-9849	Mrs Holli Dezaun Waller, DO 3700 South Main Street, Blacksburg, VA 24060 Ph: (540) 953-5445

Reviews and Comments

Family Medicine Doctors in Blacksburg, VA

Dr. Michael Howard Clary, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3700 S Main St, Suite A, Blacksburg, VA 24060 Phone: 540-443-7187 Fax: 540-443-7182
David Woodson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 215 Gilbert St, Blacksburg, VA 24060 Phone: 540-961-8040 Fax: 540-961-9466
Pete A. Guerra, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2401 S Main St Ste D, Blacksburg, VA 24060 Phone: 540-418-1910
Crystal Downer, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3700 S Main St Ste 1a, Blacksburg, VA 24060 Phone: 540-443-7180 Fax: 540-443-3725
Andrea Lynn Hall, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1645 North Main Street, Blacksburg, VA 24060 Phone: 540-552-1246 Fax: 540-552-1247
Keith Peter Madsen, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1420 N Main St, Blacksburg, VA 24060 Phone: 540-951-8380

Mrs Holli Dezaun Waller, DO - Medicare Family Practice in Blacksburg, VA