MARK RICHARD WALLACE (NPI# 1932367539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932367539 |
| Entity Type | Individual |
| Full Name | MARK RICHARD WALLACE |
| Credential | DC |
| Practice Address |
9337 W 75th St Overland Park KS 66204 |
| Practice Telephone | 9137223200 |
| Practice Fax Number | 9134328392 |
| Mailing Telephone | 9137223200 |
| Mailing Fax Number | 9134328392 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 6478 | MO | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | 04348 | KS | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | NPI | 1063617918 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533005 | Mark Thomas Wallace | Speech-Language Pathologist | 2337 N 2nd St, Harrisburg, PA 17110-1009 | 2015-11-21 |
| 1942241096 | Mark Alan Wallace | Chiropractor | 2140 W Poplar Ave, Suite 107, Collierville, TN 38017-0624 | 2006-06-09 |
| 1669467213 | Mark Spangler Wallace | Dentist | 168 N 1950 W Ste 202, Salt Lake City, UT 84116-3007 | 2005-09-20 |
| 1932104205 | Mark Randall Wallace | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259 | 2005-06-14 |
| 1760753008 | Mark Edward Wallace | Psychiatry & Neurology | 77 7th Ave, #19d, New York, NY 10011-6645 | 2012-01-18 |
| 1205110434 | Mark James Wallace | Pharmacist | 301 S Sante Fe Ave, Edmond, OK 73003 | 2011-10-06 |
| 1316119548 | Mark Steven Wallace | Hearing Instrument Specialist | 202 Grand Ave, Spencer, IA 51301 | 2008-03-27 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1104047190 | Mark C Wallace | Dentist | 50 County Road B E, Saint Paul, MN 55117-1927 | 2007-05-01 |
| 1548358047 | Mark Arthur Wallace | Dentist | 1901 Research Blvd, Suite 200, Rockville, MD 20850-3164 | 2006-10-10 |
| Street Address |
9337 W 75TH ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558326447 | Benjamin Allan Henning | Chiropractor | 9337 W 75th St, Overland Park, KS 66204-2234 | 2006-04-20 |
| 1063617918 | Wallace Chiropractic & Nutrition Clinic | Chiropractor | 9337 W 75th St, Overland Park, KS 66204 | 2007-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652405 | Avenue 81 Iaop | Assisted Living Facility | 8055 Metcalf Ave, Overland Park, KS 66204 | 2020-09-04 |
| 1487160255 | Femme Focus, L.L.C. | Clinic/Center | 7927 Floyd, Rm 5, Home Family Holistic Center, Overland Park, KS 66204 | 2017-12-15 |
| 1427577469 | Linda Kay Mufich-knopp | Physical Therapist | Femme Focus, L.L.C. In The Home Family Holistic Center, 7927 Floyd Street, Suite 5, Overland Park, KS 66204 | 2017-09-11 |
| 1700304789 | Kalli Dee Karmann | Occupational Therapy Assistant | 6814 W 72nd St, Overland Park, KS 66204 | 2017-08-30 |
| 1164951786 | Daniel Collins | Physical Therapist | 10000 W. 75th St. Ste. 250, Merriam, KS 66204 | 2017-06-07 |
| 1942686530 | Anna Katheryn Grantham | Speech-Language Pathologist | 10000 W. 75th St., Suite 250, Merriam, KS 66204 | 2015-08-05 |
| 1700262680 | Maple Hills Healthcare, Inc. | Skilled Nursing Facility | 7600 Antioch Rd, Overland Park, KS 66204 | 2015-08-03 |
| 1104211085 | John Brainard | Pediatrics | 8901 W 74th St Ste 10, Shawnee Mission, KS 66204 | 2015-03-30 |
| 1477941318 | Shelley Watts | Occupational Therapy Assistant | 6712 W 72nd Street, Overland Park, KS 66204 | 2014-12-30 |
| 1578963369 | James Aaron Mitchum | Counselor | 7923 Santa Fe Dr, Overland Park, KS 66204 | 2014-08-28 |
| Find all providers in zip 66204 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689359 | Andrew L Todd | Chiropractor | 6800 W 91st St, Overland Park, KS 66212-1453 | 2020-11-02 |
| 1336752591 | Johnathan Chase Carlin | Chiropractor | 10985 Cody St Ste 100, Overland Park, KS 66210-1219 | 2020-08-27 |
| 1538780465 | Joshua Whitmore | Chiropractor | 12101 W 110th St Ste 200, Overland Park, KS 66210-3935 | 2020-05-01 |
| 1871127985 | Katie Marie Muller | Chiropractor | 9621 W 87th St, Overland Park, KS 66212-4570 | 2020-02-27 |
| 1932748282 | Jessica Langel | Chiropractor | 7418 W 121st St, Overland Park, KS 66213-1203 | 2020-01-04 |
| 1750936290 | Roling Chiropractic and Wellness LLC | Chiropractor | 11818 W 135th St, Overland Park, KS 66221 | 2019-08-01 |
| 1083267637 | Virtue Chiropractic LLC | Chiropractor | 6511 W 119th St, Overland Park, KS 66209-2001 | 2019-07-23 |
| 1003469529 | Back On Track Chiropractic & Acupuncture LLC | Chiropractor | 9904 College Blvd, Overland Park, KS 66210-1756 | 2019-07-23 |
| 1447803630 | Nicholas James Swickard | Chiropractor | 15050 Antioch Rd Ste 102, Overland Park, KS 66221-8503 | 2019-07-17 |
| 1518519339 | Joshua Dale Roling | Chiropractor | 11818 West 135th Street, Overland Park, KS 66221 | 2019-07-11 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66204 |
Please comment or provide details below to improve the information on MARK RICHARD WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.