Jeffrey Neil Wallace, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

SO1780 Issued in MD

Practice address

330 140 Village Rd
Unit 9a
Westminster, MD 21157-6127

Phone

(410) 876-8881

Fax

(410) 848-6343

NPI assigned

May 10, 2006

Last updated

Sep 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jeffrey N Wallace DC PCGroup PAC ID 8628087327, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey N Wallace DC PC

  dba Carroll Chiropractic and Sports Injury Center

  • Chiropractor
  • Westminster, MD
  • NPI 1891813366
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1003866419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 140 VILLAGE RD",
            "address_2": "UNIT 9A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576127",
            "telephone_number": "410-876-8881",
            "fax_number": "410-848-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 140 VILLAGE RD",
            "address_2": "UNIT 9A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576127",
            "telephone_number": "410-876-8881",
            "fax_number": "410-848-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JEFFREY",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "SO1780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Zhamara Walker
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• Beverly Appl Walsh, DPT
• Ericka M Walters, LCSW-C
• Lun Wang, DDS
• Mary Jane Ward, PT

• Chiropractor in Westminster, MD
• Providers in Westminster, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.