Mitchell Dean Waller, D.C.
NPI 1457424467ActiveIndividual· Chiropractor· Phoenix, AZ
Chiropractor (D.C.) in Phoenix, Arizona, trained at Logan College of Chiropractic (class of 2000). Medicare paid $104,922 for services to 123 patients in 2024.
Overview
| NPI | 1457424467 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.C. |
| Sole proprietor | Yes |
| NPI issued | Nov 16, 2006 |
| Last updated in NPPES | Mar 1, 2026 |
| Certified by provider | Mar 1, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 8330 | AZ |
| Chiropractor, Independent Medical Examiner | 111NI0013X | 8330 | AZ |
| Chiropractor | 111N00000X | 038-009141 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Chiropractic (AZ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 123 |
|---|---|
| Services billed | 3,523 across 1 procedure code |
| Paid by Medicare | $104,922 |
Education and affiliations
| Medical school | Logan College of Chiropractic |
|---|---|
| Graduation year | 2000 |
| Medicare specialty | Chiropractic |
Medical group
- Progressive Pain Management IncCasa Grande, AZ · 37 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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