Active NPI
William Lyle Demoss, DC
- Chiropractor
- Newport Beach, CA
National Provider Identifier
1184798662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC17462
- Practice address
- 20321 SW Birch St
Suite 100
Newport Beach, CA 92660-1756 - Phone
- (949) 250-0600
- Fax
- (949) 250-1442
- NPI assigned
- Nov 17, 2006
- Last updated
- Nov 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC17462 | CA | Primary |
Addresses
Primary practice location
20321 SW Birch St
Suite 100
Newport Beach, CA 92660-1756
Mailing address
20321 SW Birch St
Suite 100
Newport Beach, CA 92660-1756
Phone (949) 250-0600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120327000106 | CA | Practitioner - Chiropractic | 7012177231 | Practice locations: Newport Beach, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
20321 SW Birch St
Suite 100
Newport Beach, CA 92660-1756
Phone (949) 250-0600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC17462 | CA | MD | Chiropractor |
| 17462 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Demoss Chiropractic | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Newport Beach, CA
- NPI 1790908879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320796800000",
"number": "1184798662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20321 SW BIRCH ST",
"address_2": "SUITE 100",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926601756",
"telephone_number": "949-250-0600",
"fax_number": "949-250-1442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20321 SW BIRCH ST",
"address_2": "SUITE 100",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926601756",
"telephone_number": "949-250-0600",
"fax_number": "949-250-1442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOSS",
"first_name": "WILLIAM",
"middle_name": "LYLE",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2011-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC17462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.