{"npi":"1215770516","type":"NPI-1","status":"active","name":{"display":"Mr. Richard Waller APRN","other":[],"first":"RICHARD","last":"WALLER","middle":"KEITH","credential":"APRN"},"specialty":{"primary_taxonomy":"363L00000X","primary_taxonomy_description":"Nurse Practitioner","slug":"nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":false,"state":"OH","license":"0036149"},{"code":"363L00000X","description":"Nurse Practitioner","primary":true,"state":"KY","license":"4047540"}]},"addresses":[{"purpose":"LOCATION","street_1":"1 MEDICAL VILLAGE DRIVE","city":"EDGEWOOD","state":"KY","postal_code":"410173403","country_code":"US","phone":"8597572927"},{"purpose":"MAILING","street_1":"1 MEDICAL VILLAGE DRIVE","city":"EDGEWOOD","state":"KY","postal_code":"410173403","country_code":"US","phone":"8597572927","fax":"8593410203"}],"license":{"state":"KY","number":"4047540"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20240904003436","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"OH","pac_id":"3870033939"},{"enrlmt_id":"I20251202003196","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"KY","pac_id":"3870033939"}]},"enumeration_date":"2024-06-14","last_updated":"2025-12-15","_meta":{"source":"NPPES","snapshot_date":"2025-12-15","doc_url":"https://findmynpi.com/api"}}