Lawrence Clifford Wallen III, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10733 Issued in FL

Practice address

21740 S Tamiami TRL
#103
Estero, FL 33928-2819

Phone

(239) 676-9116

NPI assigned

Mar 30, 2010

Last updated

Oct 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

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.

• Estero Family Chiropractic LLC

  • Chiropractor
  • Estero, FL
  • NPI 1679826705
  Medicare reassignment NPD Authorized official
• Harless Family Chiropractic, PLLC

  • Chiropractor
  • Dundee, MI
  • NPI 1033232160
  NPD (past)
• Heiserman Family Chiropractic LLC

  • Chiropractor
  • Dundee, MI
  • NPI 1063003010
  NPD (past)

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1295050516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21740 S TAMIAMI TRL",
            "address_2": "#103",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282819",
            "telephone_number": "239-676-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21740 S TAMIAMI TRL",
            "address_2": "#103",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282819",
            "telephone_number": "239-676-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "LAWRENCE",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009662",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008271600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vip Senior Care LLC
• Vital Healthcare LLC (Vital Healthcare Florida)
• Allison Vogelbach, AU.D., CCC-A, FAAA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5347)
• Walgreen Co (Walgreens #09298)
• Betcy Walter
• Warby Parker Inc.
• Matthew J Ward, M.D.
• Terry Lynn Warren, PA
• C Renee Washington-Hyde, M.D.

• Chiropractor in Estero, FL
• Providers in Estero, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.