Russell S. Wahlen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

346009-1202 Issued in UT

Practice address

1276 Wall Ave
Ogden, UT 84404-5657

Phone

(801) 337-4000

Fax

(801) 337-4002

NPI assigned

Sep 20, 2006

Last updated

May 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

• Utah Pain & Rehab LLC

  • Nurse Practitioner
  • Ogden, UT
  • NPI 1689788762

  Chiropractor

  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1104923168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 WALL AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045657",
            "telephone_number": "801-337-4000",
            "fax_number": "801-337-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 WALL AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045657",
            "telephone_number": "801-337-4000",
            "fax_number": "801-337-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLEN",
        "first_name": "RUSSELL",
        "middle_name": "S.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "346009-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Wade
• Charlotte Erin Wagner, RPH
• Jessika Wagner, MD
• Jessica Susan Wagstaff, LAT, ATC
• Jack D Wahlen, M.D.
• Norman O Wahlstrom Jr., MD
• Lara Waite, AUD
• Wake Up Sense LLC (Wake Up Sense Holistic Healing)
• Wal-Mart
• Wal-Mart Stores, Inc (Vision Center 30-2921)

• Chiropractor in Ogden, UT
• Providers in Ogden, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.