Scott G Wallace, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0700001797 Issued in OR

Practice address

2515 Crosby Ave
Klamath Falls, OR 97603-4553

Phone

(541) 883-2225

Fax

(541) 882-9388

NPI assigned

Nov 15, 2006

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

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pine Tree Chiropractic PCGroup PAC ID 3971597006, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Pine Tree Chiropractic PC

  • Chiropractor
  • Klamath Falls, OR
  • NPI 1861677783
  Medicare reassignment Care Compare group NPD Authorized official
• James M Yewchuk Chiropractic Professional Corporation

  • Chiropractor
  • Klamath Falls, OR
  • NPI 1154548295
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1770655342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 CROSBY AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034553",
            "telephone_number": "541-883-2225",
            "fax_number": "541-882-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 CROSBY AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034553",
            "telephone_number": "541-883-2225",
            "fax_number": "541-882-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SCOTT",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "0700001797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Walker, MD
• Sarah Anne Walker, QMHP-R
• Susan Marie Walker, QMHA
• Dawn Wallace, CHW
• Garrett Gene Wallace, DC
• Jordan Myungdo Walle
• Neil Marion Walle, D.D.S., M.S.
• Ronnie Lee Walles
• Chelcee Walls, CARE MANAGER
• Walmart Inc.

• Chiropractor in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.