Beverly Gail Wallis

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

158 Pointe Royale Dr Ste 140
Branson, MO 65616-3401

Phone

(501) 250-3247

NPI assigned

Mar 4, 2021

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1467047159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 POINTE ROYALE DR STE 140",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163401",
            "telephone_number": "501-250-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 POINTE ROYALE DR STE 140",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163401",
            "telephone_number": "501-250-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "BEVERLY",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-4381)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0032)
• Jaycie Lea Walden, M.S. SLP
• Walgreen Co (Walgreens #03594)
• Russell Keith Wall, D.D.S.
• Zdzislaus Joseph Wanski, M.D.
• Clinton E. Washington, PHARM. D
• Mindy Leigh Watkins, CNP
• Brenda Watson-Hill, MA, PLPC
• Sarah Opal Lynn Watts, PA

• Massage Therapist in Branson, MO
• Providers in Branson, MO by specialty
• Massage Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.