Ninth Avenue Medical Services, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH4532 Issued in FL

Legal business name

NINTH AVENUE MEDICAL SERVICES, INC.

Practice address

4455 N 9TH Ave
Pensacola, FL 32503-2830

Phone

(850) 433-9337

Fax

(850) 433-8069

NPI assigned

Feb 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Terry J. Wallace, D. C.

Title

Owner/President

Phone

(850) 433-9337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1760755490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032830",
            "telephone_number": "850-433-9337",
            "fax_number": "850-433-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032830",
            "telephone_number": "850-433-9337",
            "fax_number": "850-433-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINTH AVENUE MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "850-433-9337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH4532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Pensacola, FL
• Providers in Pensacola, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.