Jeffrey Mitchell Williams, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4054 Issued in OR

Practice address

460 N Villa Rd
Newberg, OR 97132-1800

Phone

(503) 305-6585

NPI assigned

Oct 20, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Impact Injury Center, LLC

  • Chiropractor
  • Newberg, OR
  • NPI 1124547021
  NPD (past)

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1134439409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD STE 202",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354360",
            "telephone_number": "503-305-6585",
            "fax_number": "503-344-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N VILLA RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321800",
            "telephone_number": "503-305-6585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21887 SW Sherwood Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "OR",
            "postal_code": "971409412",
            "country_code": "US",
            "telephone_number": "503-305-6585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEFFREY",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-20",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willamette Valley Mental Health LLC
• Willamette Valley Mental Health LLC
• Willamette Valley Rheumatolgy PC
• William M Bailey MD
• Alex Williams
• Jennifer M Wilson, MD
• Patrcia Wilson, MA, LMFT
• Shelby Wilson, M.A., QMHP
• Emmeline Mimi Win, RN
• Elisabeth Grace Wise, M.A., QMHP

• Chiropractor in Newberg, OR
• Providers in Newberg, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.