Individual provider Active NPI

Walter B Null, DC

  • Chiropractor
  • Canton, OH
National Provider Identifier
1316017429
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3073 Issued in OH
Practice address
4867 Munson St NW
Canton, OH 44718
Phone
(330) 494-5533
Fax
(330) 494-8101
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3073 OH Primary

Addresses

Primary practice location

4867 Munson St NW
Canton, OH 44718

Mailing address

4867 Munson St NW
Canton, OH 44718
Phone (330) 494-5533

Other identifiers 1

IdentifierTypeStateIssuer
0186025MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000117 OH Practitioner - Chiropractic 6103013941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powell Chiropractic Clinic IncGroup PAC ID 2769416155, 2 clinicians

Practice addresses (Care Compare)

4867 Munson St NW
Canton, OH 44718-3667
Phone 33049455330

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3073OHMDChiropractor

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1316017429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-494-5533",
            "fax_number": "330-494-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-494-5533",
            "fax_number": "330-494-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULL",
        "first_name": "WALTER",
        "middle_name": "B",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0186025",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.