Individual provider Active NPI

David R Willing, D.C.

  • Chiropractor
  • Grants Pass, OR
National Provider Identifier
1073663787
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 2369 Issued in OR
Practice address
237 Rogue River Hwy
Grants Pass, OR 97527-5445
Phone
(541) 476-2112
Fax
(541) 476-6294
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 2369 OR Primary

Addresses

Primary practice location

237 Rogue River Hwy
Grants Pass, OR 97527-5445

Mailing address

237 Rogue River Hwy
Grants Pass, OR 97527-5445
Phone (541) 476-2112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000177 OR Practitioner - Chiropractic 4284811332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

237 Rogue River Hwy
Grants Pass, OR 97527-5445
Phone (541) 476-2112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27 2369ORMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1073663787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 ROGUE RIVER HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275445",
            "telephone_number": "541-476-2112",
            "fax_number": "541-476-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 ROGUE RIVER HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275445",
            "telephone_number": "541-476-2112",
            "fax_number": "541-476-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLING",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 2369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.