NPIMap

Organization Active NPI

Two Chicks, LLC

  • Chiropractor
  • Annapolis, MD
National Provider Identifier
1922295948
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01998 Issued in MD
Legal business name
TWO CHICKS, LLC
Practice address
530 College Pkwy
Suite F
Annapolis, MD 21409-4614
Phone
(410) 349-2727
Fax
(410) 349-4605
NPI assigned
Oct 3, 2007
Last updated
Jul 30, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BROADNECK FAMILY CHIROPRACTICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Dr. Marissa I WallieNPI 1760589394
Title
Owner
Phone
(410) 349-2727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01998 MD Primary
Chiropractor 111N00000X 01760 MD

Addresses

Primary practice location

530 College Pkwy
Suite F
Annapolis, MD 21409-4614

Mailing address

530 College Pkwy
Suite F
Annapolis, MD 21409-4614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000040 MD Part B Supplier - Clinic/Group Practice 1456428325 Receives reassigned benefits from 3 practitioners
Practice locations: Annapolis, MD

National Provider Directory

National Provider Directory
Part of
Two Chicks LLC

Locations

530 College Pkwy
Ste F
Annapolis, MD 21409
Phone (410) 349-2727

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1922295948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 COLLEGE PKWY",
            "address_2": "SUITE F",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214094614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 COLLEGE PKWY",
            "address_2": "SUITE F",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214094614",
            "telephone_number": "410-349-2727",
            "fax_number": "410-349-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO CHICKS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROADNECK FAMILY CHIROPRACTIC",
        "enumeration_date": "2007-10-03",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "WALLIE",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-349-2727",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01998",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.