Individual provider Active NPI

William Allan Wall, D.C.

  • Chiropractor
  • Livingston, TX
National Provider Identifier
1083906036
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11759 Issued in TX
Practice address
400 Bypass LN
Suite 103
Livingston, TX 77351-6351
Phone
(936) 327-3140
Fax
(936) 327-3282
NPI assigned
May 10, 2011
Last updated
Jul 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11759 TX Primary

Addresses

Primary practice location

400 Bypass LN
Suite 103
Livingston, TX 77351-6351

Mailing address

400 Bypass LN
Suite 103
Livingston, TX 77351-6351
Phone (936) 327-3140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110714000563 TX Practitioner - Chiropractic 8022286285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jay a Workman Chiropractic Associates PCGroup PAC ID 5395744585, 2 clinicians

Practice addresses (Care Compare)

400 Bypass LN
Suite 103
Livingston, TX 77351-7380
Phone (936) 327-3140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11759TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jay a Workman Chiropractic Associates PC Chiropractor CurrentSince Apr 14, 2011 Accepting new patients

Locations

1442 Kingwood Dr
Kingwood, TX 77339

3007 Woodland Hills Dr
Kingwood, TX 77339

400 Bypass Ln
Ste 103
Livingston, TX 77352
Phone (936) 327-3140

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1083906036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BYPASS LN",
            "address_2": "SUITE 103",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773516351",
            "telephone_number": "936-327-3140",
            "fax_number": "936-327-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BYPASS LN",
            "address_2": "SUITE 103",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773516351",
            "telephone_number": "936-327-3140",
            "fax_number": "936-327-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "WILLIAM",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.