NPIMap

Organization Active NPI

Michael F. Vandewalle P.C.

  • Chiropractor
  • Austin, TX
National Provider Identifier
1154514313
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2771 Issued in TX
Legal business name
MICHAEL F. VANDEWALLE P.C.
Practice address
11824 Jollyville Rd
Suite 500
Austin, TX 78759-2322
Phone
(512) 343-0700
Fax
(512) 343-0775
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Dr. Michael F Vandewalle, D.C
Title
Dr./Owner
Phone
(512) 343-0700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2771 TX Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 11404 TX

Addresses

Primary practice location

11824 Jollyville Rd
Suite 500
Austin, TX 78759-2322

Mailing address

11824 Jollyville Rd
Suite 500
Austin, TX 78759-2322
Phone (512) 343-0700

Other identifiers 4

IdentifierTypeStateIssuer
8P0221OtherTXBCBS
11404OtherTXCHIROPRACTIC LICENSE
C06060612MedicaidTX
2771OtherTXSTATE LICENSE

National Provider Directory

National Provider Directory

Locations

11824 Jollyville Rd
Ste 500
Austin, TX 78759
Phone (512) 343-0700

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1154514313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11824 JOLLYVILLE RD",
            "address_2": "SUITE 500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787592322",
            "telephone_number": "512-343-0700",
            "fax_number": "512-343-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11824 JOLLYVILLE RD",
            "address_2": "SUITE 500",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787592322",
            "telephone_number": "512-343-0700",
            "fax_number": "512-343-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL F. VANDEWALLE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "VANDEWALLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "512-343-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2771",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11404",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8P0221",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "11404",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C06060612",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2771",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.