Individual provider Active NPI

Jon Lars Walwick, D.C.

  • Chiropractor
  • Escondido, CA
National Provider Identifier
1336252600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC22486 Issued in CA
Practice address
801 S Escondido Blvd
Escondido, CA 92025-5005
Phone
(760) 741-2805
Fax
(760) 741-9810
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC22486 CA Primary

Addresses

Primary practice location

801 S Escondido Blvd
Escondido, CA 92025-5005

Mailing address

801 S Escondido Blvd
Escondido, CA 92025-5005
Phone (760) 741-2805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111123000648 CA Practitioner - Chiropractic 3577737790 Practice locations: Escondido, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 S Escondido Blvd
Escondido, CA 92025-5005
Phone (760) 741-2806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC22486CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336252600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920255005",
            "telephone_number": "760-741-2805",
            "fax_number": "760-741-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920255005",
            "telephone_number": "760-741-2805",
            "fax_number": "760-741-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALWICK",
        "first_name": "JON",
        "middle_name": "LARS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC22486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.