Active NPI
Walter Lee Nickells, D.C.
- Chiropractor
- Luling, TX
National Provider Identifier
1467595231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6943
- Practice address
- 522 E Crockett St
Luling, TX 78648-2600 - Phone
- (830) 875-5040
- Fax
- (830) 875-5040
- NPI assigned
- Feb 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6943 | TX | Primary |
Addresses
Primary practice location
522 E Crockett St
Luling, TX 78648-2600
Mailing address
509 E Bowie St
Luling, TX 78648-3003
Phone (830) 875-5040
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6943 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467595231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 E BOWIE ST",
"city": "LULING",
"state": "TX",
"postal_code": "786483003",
"telephone_number": "830-875-5040",
"fax_number": "830-875-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 E CROCKETT ST",
"city": "LULING",
"state": "TX",
"postal_code": "786482600",
"telephone_number": "830-875-5040",
"fax_number": "830-875-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKELLS",
"first_name": "WALTER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "6943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luling, TX
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.