Organization Active NPI

Willow Health and Wellness

  • Chiropractor
  • Boone, NC
National Provider Identifier
1154920056
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILLOW HEALTH AND WELLNESS
Practice address
643 Greenway Rd Ste K1
Boone, NC 28607-4840
Phone
(828) 832-6632
NPI assigned
Oct 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Dr. Amanda Zephyr Willow Peters, DCNPI 1578965661
Title
Owner/Operator
Phone
(828) 832-6632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

643 Greenway Rd Ste K1
Boone, NC 28607-4840

Mailing address

640 Tanner Rd
Boone, NC 28607-9052
Phone (828) 832-6632

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210311001683 NC Part B Supplier - Clinic/Group Practice 7416363726 Receives reassigned benefits from 1 practitioner
Practice locations: Boone, NC

National Provider Directory

National Provider Directory

Locations

643 Greenway Rd
Ste K1
Boone, NC 28607
Phone (828) 832-6632

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1154920056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 TANNER RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286079052",
            "telephone_number": "828-832-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 GREENWAY RD STE K1",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074840",
            "telephone_number": "828-832-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ZEPHYR WILLOW",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "828-832-6632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.