Individual provider Active NPI

Jeremy Will, D.C.

  • Chiropractor
  • Concordia, KS
National Provider Identifier
1003187790
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05450 Issued in KS
Practice address
208 W 6TH St
Concordia, KS 66901-2817
Phone
(785) 262-4344
Fax
(785) 262-4346
NPI assigned
Jan 26, 2012
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05450 KS Primary

Addresses

Primary practice location

208 W 6TH St
Concordia, KS 66901-2817

Mailing address

208 W 6TH St
Concordia, KS 66901-2817
Phone (785) 262-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140304002019 KS Practitioner - Chiropractic 1850530569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 W 6TH St
Concordia, KS 66901-2817
Phone (785) 262-4344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Spine & Sport, LLC Chiropractor CurrentSince May 5, 2013 Accepting new patients
Innovative Senior Care Home Health of Kansas LLC PastSince Dec 16, 2020 Accepting new patients
Chiropractic Wellness Center PA Chiropractor PastSince Sep 1, 2015 Accepting new patients

Locations

208 W 6th St
Concordia, KS 66901
Phone (785) 262-4344

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1003187790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W 6TH ST",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669012817",
            "telephone_number": "785-262-4344",
            "fax_number": "785-262-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W 6TH ST",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669012817",
            "telephone_number": "785-262-4344",
            "fax_number": "785-262-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILL",
        "first_name": "JEREMY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-26",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concordia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.