NPIMap

Organization Active NPI

Prohealth Chiropractic, LLC

  • Chiropractor
  • Huntsville, AL
National Provider Identifier
1043409196
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2213 Issued in AL
Legal business name
PROHEALTH CHIROPRACTIC, LLC
Practice address
2124 Cecil Ashburn Dr SE
Suite 150
Huntsville, AL 35802-2574
Phone
(256) 713-1830
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Dr. Sean Patrick Wallis, DC
Title
Owner
Phone
(256) 713-8130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2213 AL Primary

Addresses

Primary practice location

2124 Cecil Ashburn Dr SE
Suite 150
Huntsville, AL 35802-2574

Mailing address

2124 Cecil Ashburn Dr SE
Suite 150
Huntsville, AL 35802-2574

Other identifiers 1

IdentifierTypeStateIssuer
51542919OtherALBC/BS

National Provider Directory

National Provider Directory

Locations

2124 Cecil Ashburn Dr SE
Ste 150
Huntsville, AL 35802
Phone (256) 539-3000

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1043409196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 CECIL ASHBURN DR SE",
            "address_2": "SUITE 150",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CECIL ASHBURN DR SE",
            "address_2": "SUITE 150",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022574",
            "telephone_number": "256-713-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-713-8130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "51542919",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.