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DR. KENNETH WALLACE D.C.
NPI 1952706673
Chiropractor in Titusville, FL

Active since October 23, 2014Accepts Medicare Assignment
119 S PARK AVE, TITUSVILLE, FL 32796(321) 226-1115(321) 251-6091 Get Directions Write a Review

NPPES record last updated: October 23, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Kenneth Wallace D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH WALLACE D.C. (NPI 1952706673) is an individual chiropractor in Titusville, Florida, licensed in Florida (CH 11302) and active in the NPI registry since October 2014. He is a graduate of Other (2006).

NPPES Registry Identity

NPI1952706673
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. KENNETH WALLACECredential: D.C.
Location Address119 S PARK AVETitusville, FL 32796-3377
Mailing Address119 S Park AveTitusville, FL 32796-3377 · (321) 226-1115 · Fax (321) 251-6091
Phone(321) 226-1115
Fax(321) 251-6091
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateOctober 23, 2014
✔ NPI 1952706673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in FL · CH 11302
Definition
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.
119 S PARK AVE, Titusville, FL 32796
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth Wallace D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729520440
PECOS Enrollment IDI20240610003640

Medicare Billing Reassignments

2

Medicare enrollment records show Kenneth Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wellspring Health - Orange City, LLC
36 mi
Chiropractor
2415 S VOLUSIA AVE STE A2
Orange City, FL 32763
  • Reassigned Medicare billing, Florida enrollment
  • 4 clinicians in this Medicare group
NPI 1760930325 (386) 775-6879
Coastal Healthcare Partners, LLC
70 mi
General Practice
50 LEANNI WAY, SUITE D1
Palm Coast, FL 32137
  • Reassigned Medicare billing, Florida enrollment
  • 8 clinicians in this Medicare group
NPI 1053762740 (386) 283-5997

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIGUEL A MEDINA MD PA
Internal Medicine
119 S PARK AVE
TITUSVILLE, FL 32796
Brevard County (321) 264-8644

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Wallace's NPI number?

The NPI number for Kenneth Wallace is 1952706673. It was assigned to this individual provider in the NPPES registry on October 23, 2014.

Where is Kenneth Wallace located?

Kenneth Wallace practices at 119 S Park Ave, Titusville, FL 32796. The listed phone number is (321) 226-1115.

What is Kenneth Wallace's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kenneth Wallace enrolled in Medicare?

Yes. Kenneth Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kenneth Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Wallace reassigns Medicare benefits to 2 organizations: Wellspring Health - Orange City, LLC (Orange City, FL) and Coastal Healthcare Partners, LLC (Palm Coast, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Wallace accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare and 3 other insurers list Kenneth Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth Wallace was last updated on October 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.