Edward C Wallace, D.C.,N.D.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A05650 Issued in IA

Practice address

5305 Herbert Hoover Hwy NE
West Branch, IA 52358-9543

Phone

(319) 643-5942

Fax

(319) 643-5942

NPI assigned

Apr 4, 2007

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609998129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 HERBERT HOOVER HWY NE",
            "city": "WEST BRANCH",
            "state": "IA",
            "postal_code": "523589543",
            "telephone_number": "319-643-5942",
            "fax_number": "319-643-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 HERBERT HOOVER HWY NE",
            "city": "WEST BRANCH",
            "state": "IA",
            "postal_code": "523589543",
            "telephone_number": "319-643-5942",
            "fax_number": "319-643-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "EDWARD",
        "middle_name": "C",
        "credential": "D.C.,N.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Rappoport, LMSW
• Shane A Staker, D.C.
• Anita Albaugh Starr, D.D.S.
• The Village Community
• Mary Kay Townsend
• West Branch Community School District

• Chiropractor in West Branch, IA
• Providers in West Branch, IA by specialty
• Chiropractor in Iowa

• 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.

Verify at the official NPI Registry.