Wallace Brain and Spine, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WALLACE BRAIN AND SPINE, PLLC

Practice address

102 Brickerton St
Columbus, MS 39701-3608

Phone

(662) 251-2195

NPI assigned

Aug 5, 2025

Last updated

Aug 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clara Bailey Wallace, DCNPI 1629795885

Title

Lead Chiropractor

Phone

(662) 251-2195

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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.

• Clara Bailey Wallace, DC

  • Chiropractor
  • Starkville, MS
  • NPI 1629795885
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1932083482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 GREENSBORO ST",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592805",
            "telephone_number": "662-251-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BRICKERTON ST",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397013608",
            "telephone_number": "662-251-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE BRAIN AND SPINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "CLARA",
        "authorized_official_middle_name": "BAILEY",
        "authorized_official_title_or_position": "LEAD CHIROPRACTOR",
        "authorized_official_telephone_number": "662-251-2195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandra Waldrep
• Walgreen Co (Rite Aid)
• Walgreen Co (Walgreens #19986)
• Walgreen Co (Walgreens #02676)
• Walgreen Co (Walgreens Specialty Pharmacy #11599)
• Ann Millsaps Wallace
• Candace Walsh
• Jackson Walters, MD
• Ryder Vancil Ward, PHARMD
• Stephanie Renay Ward, P.T.

• Chiropractor in Columbus, MS
• Providers in Columbus, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.