Jacob Waltz

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010642 Issued in MI

Practice address

14930 Laplaisance Rd
Ste 116
Monroe, MI 48161-3871

Phone

(734) 242-4422

NPI assigned

Aug 1, 2018

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Chiropractic PCGroup PAC ID 4183634728, 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 and National Provider Directory roles.

• Gateway Chiropractic, PC

  • Chiropractor
  • Monroe, MI
  • NPI 1760508246
  Medicare reassignment Care Compare group NPD
• Progressive Guidance Center of Monroe PLLC

  • Specialist
  • Monroe, MI
  • NPI 1508892951
  NPD (past)

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1922586080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "STE 116",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "STE 116",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613871",
            "telephone_number": "734-242-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J. Walker, M.A.
• Richard James Walker, D.D.S.
• Sergio Walker
• Walter J. Searcey Center, Inc.
• James Tyreill Walters, DO
• James Waltz, LBSW
• Sharon Joy Wampler, MA LPC
• Wansom Medical Center, P.C.
• Chate Wansom, M.D.
• Karen M Warren, NURSE PRACTITIONER

• Chiropractor in Monroe, MI
• Providers in Monroe, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.