Marissa I Wallie, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01998 Issued in MD

Practice address

530 College Pkwy
Suite F
Annapolis, MD 21409-4614

Phone

(410) 349-2727

Fax

(410) 349-4605

NPI assigned

Sep 17, 2006

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

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Two Chicks, LLCGroup PAC ID 1456428325, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Two Chicks, LLC

  • Chiropractor
  • Annapolis, MD
  • NPI 1922295948
  Medicare reassignment Care Compare group Authorized official
• Coastal Chiropractic LLC

  • Chiropractor
  • Easton, MD
  • NPI 1285147801
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760589394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 BRENWOODE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095494",
            "telephone_number": "410-757-3413",
            "fax_number": "410-349-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 COLLEGE PKWY",
            "address_2": "SUITE F",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214094614",
            "telephone_number": "410-349-2727",
            "fax_number": "410-349-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIE",
        "first_name": "MARISSA",
        "middle_name": "I",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rae Wall, DC
• Asher Wallace
• Gladys Wallace
• Jenny Wallace
• Scott Andrew Wallace, M.D.
• John Douglass Wallop
• John Douglass Wallop II, DPT
• Leslie Ann Wallop, P.T.
• A Terry Walman, MD
• Chantelle Marie Walsh

• Chiropractor in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Chiropractor in Maryland

• 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.