NPIMap

Organization Active NPI

Marshall M. Willis D.C., P.C.

Doing business as Mountain High Chiropractic

  • Chiropractor
  • Overgaard, AZ
National Provider Identifier
1043425622
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5288 Issued in AZ
Legal business name
MARSHALL M. WILLIS D.C., P.C.
Doing business as
Mountain High Chiropractic
Practice address
2947 Hwy 260
3
Overgaard, AZ 85933
Phone
(928) 535-6421
Fax
(928) 535-6287
NPI assigned
May 14, 2007
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Marshall M Willis, DCNPI 1942382890
Title
Owner
Phone
(928) 535-6421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5288 AZ Primary

Addresses

Primary practice location

2947 Hwy 260
3
Overgaard, AZ 85933

Mailing address

PO Box 340
Overgaard, AZ 85933-0340
Phone (928) 535-6421

Other names 1

  • Mountain High Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1043425622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "859330340",
            "telephone_number": "928-535-6421",
            "fax_number": "928-535-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2947 HWY 260",
            "address_2": "3",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "85933",
            "telephone_number": "928-535-6421",
            "fax_number": "928-535-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL M. WILLIS D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-535-6421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain High Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overgaard, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.