Individual provider Active NPI

Dean Allen Willhite, DC

  • Chiropractor
  • Manitowoc, WI
National Provider Identifier
1053344168
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2747 Issued in WI
Practice address
3713 Calumet Avenue
Manitowoc, WI 54220-5433
Phone
(920) 682-6680
Fax
(920) 682-6983
NPI assigned
Jul 9, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2747 WI Primary

Addresses

Primary practice location

3713 Calumet Avenue
Manitowoc, WI 54220-5433

Mailing address

3713 Calumet Avenue
Manitowoc, WI 54220-5433
Phone (920) 682-6680

Other identifiers 2

IdentifierTypeStateIssuer
35574OtherMEDICARE ID
38863600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000792 WI Practitioner - Chiropractic 5193714756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3713 Calumet Ave
Manitowoc, WI 54220-5433
Phone (920) 682-6680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas & Willhite Chiropractic Clinic, LTD. CurrentSince May 27, 1997 Accepting new patients

Locations

3713 Calumet Ave
Manitowoc, WI 54220
Phone (920) 682-6680

Organizations & group practices 1

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1053344168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 CALUMET AVENUE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205433",
            "telephone_number": "920-682-6680",
            "fax_number": "920-682-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3713 CALUMET AVENUE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205433",
            "telephone_number": "920-682-6680",
            "fax_number": "920-682-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLHITE",
        "first_name": "DEAN",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "35574",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38863600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.