DR. ELLEN D. WALTHALL (MD) – Surgery Physician, NPI 1174694707
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,050 EMERGENCY MEDICINE in TX
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Provider Addresses for DR. ELLEN D. WALTHALL (MD)
301, Jenny George Lane, Sweetwater, Nolan County, Texas, 79556, United States
SWEETWATER, TX 795567152
Phone: (325) 236-8886
Fax: (325) 236-8861
Type: Location
1403, County Road 2102, Lometa, Lampasas County, Texas, 76853, United States
LOMETA, TX 768533444
Phone: (417) 718-5754
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-12-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20091221000672 | I | General Surgery | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79556)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Family Practice, Obstetrics/Gynecology | TX | |
| Family Practice | TX | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | TX | |
| Nephrology, Internal Medicine | TX | |
| - | TX | |
| Family Practice | TX | |
| Family Practice | FL | |
| Nurse Practitioner | TX |
Reviews
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