Individual provider Active NPI

Christine Wallen, DC

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1710371190
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
076948 Issued in IA
Practice address
3221 16TH Ave SW
Cedar Rapids, IA 52404-1453
Phone
(319) 396-2300
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 076948 IA Primary

Addresses

Primary practice location

3221 16TH Ave SW
Cedar Rapids, IA 52404-1453

Mailing address

410 Camden St
North Liberty, IA 52317-7604

Other names 1

  • Dr. Christine R Wallen Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180404002873 FL Practitioner - Chiropractic 0244551794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic and Massage of North PortGroup PAC ID 3870856834, 3 clinicians

Practice addresses (Care Compare)

14942 Tamiami TRL
Suite L
North Port, FL 34287-2705
Phone (941) 564-8083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic & Massage of North Port Chiropractor CurrentSince Nov 20, 2017 Accepting new patients

Locations

14942 Tamiami Trl
Ste L
North Port, FL 34287
Phone (815) 545-6307

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1710371190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CAMDEN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523177604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 16TH AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041453",
            "telephone_number": "319-396-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "CHRISTINE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "076948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "WALLEN",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.