Maurice Shekeil Wallace

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3402 Issued in SC

Practice address

2645 Whiskey Rd
Suite 109
Aiken, SC 29803-8075

Phone

(706) 339-5205

NPI assigned

Dec 26, 2008

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 SC

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

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.

• Spine Doctors of Aiken LLC

  • Chiropractor
  • Aiken, SC
  • NPI 1053557843
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230249600000",
    "number": "1902042872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 WHISKEY RD",
            "address_2": "SUITE 109",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298038075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 WHISKEY RD",
            "address_2": "SUITE 109",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298038075",
            "telephone_number": "706-339-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MAURICE",
        "middle_name": "SHEKEIL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-26",
        "last_updated": "2008-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Donmonique Nicole Walker
• Lasaundria Janai Walker, LPC
• Mackie J Walker Jr., DPM
• Matthew Tyler Wall, DMD
• Annie Walters
• Annie Wang
• Jing Wang, M.D.
• Afsar M Waraich, MD
• Jennifer Warden, MED

• Chiropractor in Aiken, SC
• Providers in Aiken, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2008; 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.