Joshua Wallert, DC

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

6545 Issued in MN

Practice address

4490 Erin Dr
Eagan, MN 55122

Phone

(651) 209-9906

NPI assigned

Nov 7, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• MTN Health Chiro & Neurology Ctr LLC

  • Neurology Chiropractor
  • Englewood, CO
  • NPI 1164545638
  NPD (past)

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1790114049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 ERIN DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222357",
            "telephone_number": "651-209-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 ERIN DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-209-9906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16830 Northgate Dr",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801345778",
            "country_code": "US",
            "telephone_number": "303-805-7246",
            "fax_number": "303-840-7159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLERT",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CO",
            "license": "0007075",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "MN",
            "license": "6545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Mark Wagner, RPH
• Wal-Mart Stores, Inc. (Vision Center 30-1786)
• Walgreen Co (Walgreens #05081)
• Walgreen Co (Walgreens #10641)
• Walgreen Co (Walgreens #02766)
• James Wallisch
• Walmart Inc. (Walmart Pharmacy 10-1786)
• Emily Walsh
• Natasha Walters, DC
• Robalee Wanderman, M.D.

• Neurology Chiropractor in Eagan, MN
• Providers in Eagan, MN by specialty
• Neurology Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.