Active NPI
Jaisa Ann Williams Wallerich, DC
- Chiropractor
- Savage, MN
National Provider Identifier
1871272484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7125
- Practice address
- 8678 Eagle Creek Cir
Savage, MN 55378-4400 - Phone
- (952) 432-3333
- NPI assigned
- Jul 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7125 | MN | Primary |
Addresses
Primary practice location
8678 Eagle Creek Cir
Savage, MN 55378-4400
Mailing address
8375 W 103Rd St
Bloomington, MN 55438-1926
Other names 1
- Miss Jaisa Ann Williams
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7125 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1871272484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8375 W 103RD ST",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554381926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8678 EAGLE CREEK CIR",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553784400",
"telephone_number": "952-432-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLERICH",
"first_name": "JAISA",
"middle_name": "ANN WILLIAMS",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-12",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "7125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JAISA",
"last_name": "WILLIAMS",
"middle_name": "ANN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Savage, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.