DR. NATHAN RANDALL WALL (NPI# 1578810123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578810123 |
| Entity Type | Individual |
| Full Name | DR. NATHAN RANDALL WALL |
| Credential | D.C. |
| Practice Address |
12197 S Draper Gate Dr Draper UT 84020-8078 |
| Mailing Address |
12197 S. Draper Gate Dr. Ste. 108 Silverdale UT 98383-8301 |
| Practice Telephone | 8015900600 |
| Practice Fax Number | 8015900643 |
| Mailing Telephone | 8015900600 |
| Mailing Fax Number | 8015900643 |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2018-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NP0017X |
Chiropractor Specialization: Pediatric Chiropractor |
6145802-1202 | UT | Chiropractic Providers |
| Street Address |
12197 S DRAPER GATE DR |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-8078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 111NP0017X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Pediatric Chiropractor |
| The Pediatric Chiropractor is a chiropractor with specialized, advanced training and certification in the evaluation, care and management of health and wellness conditions of infancy, childhood and adolescence. This specialist provides primary, comprehensive, therapeutic and preventative chiropractic health care for newborns through adolescents. |
| Notes: Source: Council on Chiropractic Pediatrics, American Chiropractic Association, 2007 [1/1/2008: new] |
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| 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.