Willis Family Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1268, CHIA-1267 Issued in ID

Legal business name

WILLIS FAMILY CHIROPRACTIC, LLC

Practice address

10451 W Garverdale CT
Suite 201
Boise, ID 83704-5408

Phone

(208) 322-4114

Fax

(208) 322-4115

NPI assigned

Apr 22, 2008

Last updated

Oct 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Willis, DCNPI 1093992539

Title

Chiropractor, Owner

Phone

(208) 322-4114

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

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.

• Nicole Willis, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1093992539
  Medicare reassignment Care Compare group NPD Authorized official
• Chad C Willis, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1053598599
  Medicare reassignment Care Compare group
• Michael W Hurd, D.D.S.

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1104869841
  NPD (past)

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1114191137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10451 W GARVERDALE CT",
            "address_2": "SUITE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045408",
            "telephone_number": "208-322-4114",
            "fax_number": "208-322-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10451 W GARVERDALE CT",
            "address_2": "SUITE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045408",
            "telephone_number": "208-322-4114",
            "fax_number": "208-322-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CHIROPRACTOR, OWNER",
        "authorized_official_telephone_number": "208-322-4114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1268, CHIA-1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Quinn Williams, MS, LCPC, NCC
• Yaa-Serwa Williams, LICSW, LISW-CP
• Stephen W Williamson, PA
• Sydney Rose Williamson
• Tyler Williamson, PHARMD
• Deanna Willis, MS CF SLP
• Elsa Francis Willis
• Tanna Susan Willis, LCMT
• Willow Grove Wellness
• Willow Oaks Health

• Chiropractor in Boise, ID
• Providers in Boise, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.