Individual provider Active NPI

Wallace K Massah, DC

  • Chiropractor
  • Roxbury, MA
National Provider Identifier
1144640632
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3444 Issued in MA
Practice address
190 Dudley St
Roxbury, MA 02119-2573
Phone
(617) 442-8600
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3444 MA Primary

Addresses

Primary practice location

190 Dudley St
Roxbury, MA 02119-2573

Mailing address

190 Dudley St
Roxbury, MA 02119-2573
Phone (617) 442-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3444MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Soapy C Enterprises LLC Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1144640632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 DUDLEY ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192573",
            "telephone_number": "617-442-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 DUDLEY ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021192573",
            "telephone_number": "617-442-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSAH",
        "first_name": "WALLACE",
        "middle_name": "K",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.