Jason W Wall, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A06211 Issued in IA

Practice address

115 1St Ave W
Dyersville, IA 52040-1104

Phone

(563) 875-9255

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Chiropractic IncGroup PAC ID 7810020062, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• City Chiropractic Inc

  • Chiropractor
  • Dyersville, IA
  • NPI 1104130590
  Medicare reassignment Care Compare group NPD Authorized official
• Kvbdcpc

  • Chiropractor
  • Dyersville, IA
  • NPI 1427186048
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1811048093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 1ST AVE W",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520401104",
            "telephone_number": "563-875-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 1ST AVE W",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520401104",
            "telephone_number": "563-875-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "JASON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDVIDUAL PROVIDER #",
            "identifier": "48459",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Ellen Kennedy Living Center
• Susan Lynn Theisen, LAT,ATC
• Jacqueline Timp, DPT
• Robert Stanley Tomas, M.D.
• Jack Allen Tressel, DC
• Williams Chiropractic, PLLC
• Blake Aaron Williams, D.C.
• Woodland Eye Clinic, PC (The Woodland Eye Clinic)

• Chiropractor in Dyersville, IA
• Providers in Dyersville, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.