Individual provider Active NPI

Megan Wall, D.C.

  • Chiropractor
  • Shakopee, MN
National Provider Identifier
1356766760
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5901 Issued in MN
Practice address
8439 Grove PL
Shakopee, MN 55379-8518
Phone
(712) 251-0388
NPI assigned
Feb 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5901 MN Primary

Addresses

Primary practice location

8439 Grove PL
Shakopee, MN 55379-8518

Mailing address

5201 Eden Ave
Ste 190
Edina, MN 55436-2368
Phone (952) 920-9721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140611001430 MN Practitioner - Chiropractic 9537383641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5201 Eden Ave
Suite 190
Edina, MN 55436-2368
Phone (952) 920-9721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marty Clinic PA Chiropractor CurrentSince Jun 7, 2014 Accepting new patients

Locations

5201 Eden Ave
Ste 190
Minneapolis, MN 55436
Phone (952) 920-9721

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.

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1356766760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 EDEN AVE",
            "address_2": "STE 190",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362368",
            "telephone_number": "952-920-9721",
            "fax_number": "952-241-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8439 GROVE PL",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553798518",
            "telephone_number": "712-251-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MEGAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.