Healthsource Huntsville-the Rocket City LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

HEALTHSOURCE HUNTSVILLE-THE ROCKET CITY LLC

Practice address

2915 Bob Wallace Ave SW Ste B
Huntsville, AL 35805-4107

Phone

(256) 880-8833

NPI assigned

Apr 3, 2023

Last updated

Apr 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sean Wallis, DCNPI 1245431501

Title

Owner

Phone

(256) 880-8833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sean Patrick Wallis, DC

  • Rehabilitation Chiropractor
  • Huntsville, AL
  • NPI 1245431501
  Medicare reassignment Care Compare group NPD Authorized official
• Courtney Elizabeth Hayden, DC

  • Chiropractor
  • Huntsville, AL
  • NPI 1326625492

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Tracy Glen Bagwell, DC

  • Chiropractor
  • Huntsville, AL
  • NPI 1821028325
  NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1477258275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 BOB WALLACE AVE SW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054107",
            "telephone_number": "256-880-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 BOB WALLACE AVE SW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054107",
            "telephone_number": "256-880-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE HUNTSVILLE-THE ROCKET CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-880-8833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthcare Authority of the City of Huntsville (Huntsville Hospital Walk In Clinic at Airport Road)
• Healthcare Authority of the City of Huntsville (North Alabama Hospitalist)
• Healthgroup of Alabama
• Healthgroup of Alabama, LLC (Home Health Group - Huntsville)
• Healthplus Chiropractic, Inc.
• Healthsource of Huntsville, LLC
• Healthsource of Providence LLC
• Healthy Smiles PC
• Brooke A Healy, CRNA
• Hearing & Speech Clinic of Huntsville, Inc.

• Rehabilitation Chiropractor in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Rehabilitation Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.