Renee Ann Wallesen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

020578261 Issued in NE

Practice address

113 W 3Rd St
Alliance, NE 69301-3301

Phone

(308) 762-9333

Fax

(308) 762-2223

NPI assigned

Jun 9, 2006

Last updated

Aug 27, 2013By 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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1609817089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1496",
            "city": "ANGORA",
            "state": "NE",
            "postal_code": "693311496",
            "telephone_number": "308-762-9333",
            "fax_number": "308-762-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W 3RD ST",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693013301",
            "telephone_number": "308-762-9333",
            "fax_number": "308-762-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLESEN",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "020578261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "232114",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA",
            "identifier": "020578261",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36634",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PALMETTO",
            "identifier": "P00801937",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Janet Kay Walker
• Makenzi Walsh
• Molli Washington
• Gladys Muriel Welch
• Rebecca Lynn Wellnitz
• Vanessa Werner

• Chiropractor in Alliance, NE
• Providers in Alliance, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.