DR. SCOTT MATTHEW WALLACE (NPI# 1629139563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629139563 |
Entity Type | Individual |
Full Name | DR. SCOTT MATTHEW WALLACE |
Credential | D.C. |
Practice Address |
8960 W Cheyenne Ave Suite 110 Las Vegas NV 89129-8929 |
Practice Telephone | 7024746996 |
Practice Fax Number | 7026554389 |
Mailing Telephone | 7024746996 |
Mailing Fax Number | 7026554389 |
Enumeration Date | 2006-12-13 |
Last Update Date | 2015-03-31 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | B383 | NV | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | BLUE CROSS BLUE SHIELD | NV3648 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275809899 | Scott Andrew Wallace | Student in an Organized Health Care Education/Training Program | Navy Medicine Support Command Attn: Med Staff Services, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2012-03-28 |
1184996399 | Scott D Wallace | Social Worker | 63 Glenwood St, Lowell, MA 01852-3007 | 2012-02-02 |
1770655342 | Scott G Wallace | Chiropractor | 2515 Crosby Ave, Klamath Falls, OR 97603-4553 | 2006-11-15 |
1558381822 | Scott Christopher Wallace | Anesthesiology | Po Box 112, Muncie, IN 47308-0112 | 2006-07-20 |
1831611839 | Scott Christopher Wallace | Nurse Practitioner | 1900 S Main St, Findlay, OH 45840-1214 | 2017-07-11 |
1104359975 | Scott Robert Wallace | Psychiatry & Neurology | 103 N Loop 499, Harlingen, TX 78550-2557 | 2017-04-07 |
1922441880 | Scott Michael Wallace | Pediatrics | 75 Pringle Way, Ste 300, Reno, NV 89502-1464 | 2013-04-10 |
1134414220 | Scott Eric Wallace | Pharmacist | 1214 N Market Blvd, Suite C, Sacramento, CA 95834-2931 | 2011-06-16 |
1568755114 | Scott Wallace | Technician, Other | 4801 Reading St, Dallas, TX 75247-6716 | 2011-05-16 |
1265613855 | Scott Arthur Wallace | Physician Assistant | 3643 N Roxboro St, Durham Regional Hospital Emergency Department, Durham, NC 27704-2702 | 2007-11-25 |
Street Address |
8960 W CHEYENNE AVE SUITE 110 |
City | LAS VEGAS |
State | NV |
Zip Code | 89129-8929 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588938054 | Active Nevada Chiropractic & Wellness, LLC | Chiropractor | 8960 W Cheyenne Ave, Suite 110, Las Vegas, NV 89129-8929 | 2012-03-01 |
1427209055 | Scott M Wallace Ltd | Chiropractor | 8960 W Cheyenne Ave, Suite 110, Las Vegas, NV 89129-8929 | 2008-10-01 |
1528197316 | Rhett K Beaman | Chiropractor | 8960 W Cheyenne Ave, Suite 110, Las Vegas, NV 89129-8929 | 2007-03-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699387621 | Voice Specialist LLC | Speech-Language Pathologist | 3701 Paul Deweert Ct, Las Vegas, NV 89129 | 2020-08-20 |
1215563358 | Aba Homecare LLC | In Home Supportive Care | 4456 N Prospect Hill Ct, Las Vegas, NV 89129 | 2020-03-20 |
1568935534 | Las Vegas Family Medicine Inc. | Family Medicine | 7660 W. Cheyenne Ave Suite 110, Las Vegas, NV 89129 | 2019-01-02 |
1477040798 | Cynthia Beverly Springer | Technician | 8670 West Cheyenne Suite 135, Las Vegas, NV 89129 | 2018-04-23 |
1518471093 | 3 Pharmacy LLC | Pharmacy | 3350 Novat St Ste 110, Las Vegas, NV 89129 | 2017-11-20 |
1497207393 | Morgan A Lavergne | Behavioral Analyst | 7650 Siesta Grande Ave., Las Vegas, NV 89129 | 2016-10-27 |
1255880191 | Sierra Treatment and Recovery Services, LLC | Clinic/Center | 3321 N. Buffalo Dr., Suite #125, Las Vegas, NV 89129 | 2016-10-03 |
1710433545 | Tyson Miller | Dentist | 3600 N Buffalo Dr., #110, Las Vegas, NV 89129 | 2016-08-31 |
1427450923 | Jerale Tiffith | Behavioral Analyst | 3800 Dalecrest Dr., 2801, Las Vegas, NV 89129 | 2014-09-16 |
1134463821 | Paul Carr | Behavioral Analyst | 4460 Park Ave, Las Vegas, NV 89129 | 2012-11-19 |
Find all providers in zip 89129 |
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 |
---|---|---|---|---|
1013516228 | Hernandez Chiropractic LLC. | Chiropractor | 2829 S Rainbow Blvd, Las Vegas, NV 89146-5166 | 2020-10-19 |
1508475203 | Powerhouse Physical Therapy LLC | Chiropractor | 3050 E Bonanza Rd Ste 110d, Las Vegas, NV 89101-3706 | 2020-07-28 |
1366077067 | Josephine N Stanton | Chiropractor | 8475 S Eastern Ave Ste 101, Las Vegas, NV 89123-2863 | 2020-03-03 |
1194356220 | Joshua Lawrence Sharpe | Chiropractor | 410 S Rampart Blvd Ste 340, Las Vegas, NV 89145-5730 | 2020-01-28 |
1104466713 | The Muscle, Joint & Spine Center, Inc. | Chiropractor | 9516 W Flamingo Rd Ste 125, Las Vegas, NV 89147-5748 | 2020-01-11 |
1831730894 | Daniel Stellavato | Chiropractor | 11014 Calcedonian St, Las Vegas, NV 89141-4328 | 2019-10-01 |
1184272601 | Andrea Watson | Chiropractor | 10420 S Decatur Blvd Ste 140, Las Vegas, NV 89141-8717 | 2019-08-28 |
1760940555 | Willie So | Chiropractor | 1263 E Silverado Ranch Blvd Ste 105a, Las Vegas, NV 89183-5946 | 2019-03-11 |
1861962052 | Light Brothers, LLC | Chiropractor | 10040 W Cheyenne Ave Ste 130, Las Vegas, NV 89129-7720 | 2018-11-29 |
1073099354 | Alignology, LLC | Chiropractor | 10470 W Cheyenne Ave Ste 115, Las Vegas, NV 89129-8733 | 2018-07-19 |
Find all providers in LAS VEGAS |
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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.