DR. ROGER D. WALLIS (NPI# 1063615243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063615243 |
| Entity Type | Individual |
| Full Name | DR. ROGER D. WALLIS |
| Credential | P.C. |
| Practice Address |
419 Denver Ave Fort Lupton CO 80621-1823 |
| Practice Telephone | 3038576344 |
| Mailing Telephone | 3038576344 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2007-12-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1509 | CO | Chiropractic Providers |
| Street Address |
419 DENVER AVE |
| City | FORT LUPTON |
| State | CO |
| Zip Code | 80621-1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083894489 | Roger D Wallis Dcpc | Chiropractor | 419 Denver Ave, Fort Lupton, CO 80621-1823 | 2007-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659741247 | Workwellness Inc | Clinic/Center | 1450 Dexter Ave, Fort Lupton, CO 80621 | 2015-09-25 |
| 1386902294 | Kathryn M. Bowker | Counselor | 260 College Ave, Fort Lupton, CO 80621 | 2012-04-27 |
| 1225241946 | Theresa S Doi | Physical Therapist | 721 4th Street, Suite B, Fort Lupton, CO 80621 | 2007-05-08 |
| 1003946450 | Terry W Williams Dc PC | Chiropractor | 331 Park Avenue, Fort Lupton, CO 80621 | 2007-03-06 |
| 1548326200 | Glenda P Walden | Counselor | 120 1st Street, Ft. Lupton, CO 80621 | 2006-12-28 |
| 1447329099 | Caring Hands Pharmacy Inc | Pharmacy | 105 Dales Place, Fort Lupton, CO 80621 | 2006-11-07 |
| 1942382023 | Ft Lupton Medical Team PC | Family Medicine | 308 Denver Ave, Fort Lupton, CO 80621 | 2006-10-19 |
| 1841393253 | Irene Margaret Holloman | Dentist | 229 Denver Ave, Fort Lupton, CO 80621 | 2006-09-07 |
| 1346575586 | North Range Behavioral Health | Clinic/Center | 145 1st St, Fort Lupton, CO 80621 | 2009-10-06 |
| 1366620775 | Terry Wade Williams | Chiropractor | 331 Park Ave, Fort Lupton, CO 80621 | 2008-02-07 |
| Find all providers in zip 80621 | ||||
| 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 |
|---|---|---|---|---|
| 1003946450 | Terry W Williams Dc PC | Chiropractor | 331 Park Avenue, Fort Lupton, CO 80621 | 2007-03-06 |
| 1366620775 | Terry Wade Williams | Chiropractor | 331 Park Ave, Fort Lupton, CO 80621 | 2008-02-07 |
| 1083894489 | Roger D Wallis Dcpc | Chiropractor | 419 Denver Ave, Fort Lupton, CO 80621-1823 | 2007-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890704 | Bekah Peterson | Chiropractor | 1550 Main St Unit 112, Windsor, CO 80550-7916 | 2020-10-29 |
| 1548860836 | Kirton Chiropractic LLC | Chiropractor | 6841 W Asbury Pl, Lakewood, CO 80227-2690 | 2020-10-27 |
| 1427657881 | Robert Spackman | Chiropractor | 1485 Garden of The Gods Rd Ste 156, Colorado Springs, CO 80907-3306 | 2020-10-18 |
| 1588271167 | Nichole Geary | Chiropractor | 2355 N Lafayette St Apt 1, Denver, CO 80205-5381 | 2020-09-28 |
| 1548875586 | Ao Colorado Pllc | Chiropractor | 103 Fourth Street, Suite 330, Castle Rock, CO 80104-2449 | 2020-09-15 |
| 1710592779 | Ao Colorado Pllc | Chiropractor | 6901 S. Yosemite Street, Suite 102, Centennial, CO 80112-1413 | 2020-09-15 |
| 1932713351 | Jeffrey Lee Houston | Chiropractor | 1519 Park Central Dr, Highlands Ranch, CO 80129-2759 | 2020-09-02 |
| 1851904023 | 100 Chiro Peterson Three LLC | Chiropractor | 5714 W 89th Ave, Westminster, CO 80031 | 2020-08-28 |
| 1811508369 | Haak Chiropractic LLC | Chiropractor | 6666 Gunpark Dr Ste 100, Boulder, CO 80301-3396 | 2020-08-10 |
| 1992315915 | Andrew Phelan Dc PC | Chiropractor | 6169 S Balsam Way Ste 310, Littleton, CO 80123-3064 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
| City | FORT LUPTON |
| Zip Code | 80621 |
Please comment or provide details below to improve the information on DR. ROGER D. WALLIS.
| 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.