Brian F Wallace, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 006829L Issued in PA

Practice address

306 Main St
Brookville, PA 15825-1222

Phone

(814) 849-5607

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brookville Chiropractic & Rehabilitation Center, LLC

  • Rehabilitation Chiropractor
  • Brookville, PA
  • NPI 1518172196
  Medicare reassignment NPD Authorized official
• Wise Chiropractic & Rehabilitation Center Inc

  • Chiropractor
  • Lock Haven, PA
  • NPI 1316936602
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649269788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251222",
            "telephone_number": "814-849-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251222",
            "telephone_number": "814-849-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BRIAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC 006829L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "815891",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016298480006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "75611",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Thomas, PA-C
• Thomas N Thomas, CRNA
• Justine Marie Toven, PA-C
• Stewart D Vanhorn, M.D.
• Lisa M Vivian, PA
• William J Weaver, DMD
• Kortney Marie Wiant
• William J. Lynch, D.O., Inc.
• Amanda Renee Williams, COTA
• Lisa A. Witherite-Rieg, D.O.

• Chiropractor in Brookville, PA
• Providers in Brookville, PA by specialty
• Chiropractor in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.