Active NPI
Christopher James Derrick Wallis, MD, PHD
- Urology Physician
- Nashville, TN
National Provider Identifier
1356903652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 58513
- Practice address
- 3601 The Vanderbilt Clinic
Nashville, TN 37232-0001 - Phone
- (615) 936-2000
- NPI assigned
- Jul 8, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 58513 | TN | Primary |
Addresses
Primary practice location
3601 The Vanderbilt Clinic
Nashville, TN 37232-0001
Mailing address
719 Thompson LN Ste 30330
Nashville, TN 37204-4701
Other practice location 1
A1302 Medical Center North
Nashville, TN 37232-0001
Phone (615) 322-2101
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cwallis448002@direct.vumc.org | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1356903652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 THOMPSON LN STE 30330",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372044701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 THE VANDERBILT CLINIC",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372320001",
"telephone_number": "615-936-2000"
}
],
"practiceLocations": [
{
"address_1": "A1302 Medical Center North",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372320001",
"country_code": "US",
"telephone_number": "615-322-2101",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLIS",
"first_name": "CHRISTOPHER",
"middle_name": "JAMES DERRICK",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-08",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TN",
"license": "58513",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cwallis448002@direct.vumc.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Health Information Service Provider",
"address_1": "3601 The Vanderbilt Clinic",
"city": "Nashville",
"state": "TN",
"country_code": "US",
"postal_code": "372320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.