Marybelle Walden, CHIROPRACTOR DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2181 Issued in TN

Practice address

450 N Main St
Suite 2
Jellico, TN 37762-2136

Phone

(423) 372-0000

Fax

(423) 372-0000

NPI assigned

Jun 21, 2007

Last updated

Sep 9, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Networks

• MS PPO
• AL HMO D-SNP
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• MS PPO C-SNP
• KY PPO
• TN PPO C-SNP
• MS PPO D-SNP
• AL HMO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• KY PPO C-SNP
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• TN PPO

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1013113711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N. MAIN ST.",
            "address_2": "SUITE 2",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "37762",
            "telephone_number": "423-372-0000",
            "fax_number": "423-372-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N MAIN ST",
            "address_2": "SUITE 2",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622136",
            "telephone_number": "423-372-0000",
            "fax_number": "423-372-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "MARYBELLE",
        "credential": "CHIROPRACTOR DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2181",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathleen Connie Suto, M.D.
• Emily Terry, PHARMD
• Geogy Thomas, M.D.
• Shonda Lynn Tucker, APRN
• Susanne Urich, RN
• Walgreen Co (Walgreens #18950)
• Natalie Ruth Wilbanks, PA-C
• Wilkens Medical Group Inc.
• Darryl John Wilkens, M.D.
• Windham Drug Jellico, Inc (Windham Drug Jellico)

• Chiropractor in Jellico, TN
• Providers in Jellico, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.