Individual provider Active NPI

Wayne M. London, D.C.

  • Chiropractor
  • Brookline, MA
National Provider Identifier
1417006933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2263 Issued in MA
Practice address
1842 Beacon St
Suite 402
Brookline, MA 02445-1930
Phone
(617) 735-9656
Fax
(617) 735-9696
NPI assigned
Jan 10, 2007
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 2263 MA Primary

Addresses

Primary practice location

1842 Beacon St
Suite 402
Brookline, MA 02445-1930

Mailing address

1842 Beacon St
Suite 402
Brookline, MA 02445-1930
Phone (617) 735-9656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051220000469 MA Practitioner - Chiropractic 2668494568 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1842 Beacon St
Suite 205
Brookline, MA 02445-1900

1842 Beacon St
Suite 205
Brookline, MA 02445-1922
Phone (617) 735-9656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2263MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417006933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST",
            "address_2": "SUITE 402",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-735-9656",
            "fax_number": "617-735-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST",
            "address_2": "SUITE 402",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-735-9656",
            "fax_number": "617-735-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "WAYNE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

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.