Active NPI
David George Wallwork, LAT
- Specialist
- Sarasota, FL
National Provider Identifier
1245498740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AL 532
- Practice address
- 7668 S Tamiami TRL
Sarasota, FL 34231-6884 - Phone
- (941) 926-2622
- NPI assigned
- May 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AL 532 | FL | Primary |
Addresses
Primary practice location
7668 S Tamiami TRL
Sarasota, FL 34231-6884
Mailing address
7668 South Tamiami Trail
Sarasota, FL 34231
Phone (941) 926-2622
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL 532 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1245498740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7668 SOUTH TAMIAMI TRAIL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "34231",
"telephone_number": "941-926-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7668 S TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342316884",
"telephone_number": "941-926-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLWORK",
"first_name": "DAVID",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-30",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "AL 532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.