Individual provider Active NPI

Jennifer Rae Wall, DC

  • Chiropractor
  • Annapolis, MD
National Provider Identifier
1205429024
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04108 Issued in MD
Practice address
530 College Pkwy
Ste F
Annapolis, MD 21409
Phone
(410) 349-2727
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 04108 MD Primary

Addresses

Primary practice location

530 College Pkwy
Ste F
Annapolis, MD 21409

Mailing address

530 College Pkwy Ste F
Annapolis, MD 21409-4614
Phone (410) 349-2727

Other names 1

  • Dr. Jennifer Rae Scanlon Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113004072 MD Practitioner - Chiropractic 4688080096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Two Chicks, LLCGroup PAC ID 1456428325, 3 clinicians

Practice addresses (Care Compare)

530 College Pkwy
Suite F
Annapolis, MD 21409-4614
Phone (410) 349-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04108MDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Two Chicks, LLC Chiropractor CurrentSince Oct 28, 2024 Accepting new patients
Back and Neck Center of Brick LLC Chiropractor CurrentSince Dec 1, 2023 Accepting new patients

Locations

530 College Pkwy
Ste F
Annapolis, MD 21409
Phone (410) 349-2727

387 Brick Blvd
Brick, NJ 08723
Phone (732) 477-6767

Organizations & group practices 2

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": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1205429024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 COLLEGE PKWY STE F",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214094614",
            "telephone_number": "410-349-2727",
            "fax_number": "410-349-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 COLLEGE PKWY",
            "address_2": "STE F",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21409",
            "telephone_number": "410-349-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "04108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SCANLON",
            "middle_name": "RAE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.