David Stuart Wallace, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006811 Issued in MO

Practice address

2330 Highway 94 South Outer Rd
Saint Charles, MO 63303-8301

Phone

(636) 498-2346

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Adio Family Chiropractic, LLC

  • Chiropractor
  • Saint Charles, MO
  • NPI 1649542341
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386868487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 HIGHWAY 94 SOUTH OUTER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633038301",
            "telephone_number": "636-498-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 HIGHWAY 94 SOUTH OUTER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633038301",
            "telephone_number": "636-498-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DAVID",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "131625",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3391509",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4400088",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary L. Walker, PLPC
• Tricia Walker
• William V Walker, MD
• John M Walkonis, DDS
• Aimee Rose Wallace, MA, LPC
• Mary Wallace, OTR
• Joseph G Waller, M.D., M.P.H.
• James Walsh
• Martin J Walsh, M.D.
• Alexandria Michelle Walter, M.S., CCC-SLP

• Chiropractor in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Chiropractor in Missouri

• 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.