Individual provider Active NPI

Jeffrey Will, DC

  • Chiropractor
  • Anoka, MN
National Provider Identifier
1184996365
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6353 Issued in MN
Practice address
646 E River Rd Ste 4
Anoka, MN 55303-1891
Phone
(763) 421-1410
NPI assigned
Feb 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6353 MN Primary

Addresses

Primary practice location

646 E River Rd Ste 4
Anoka, MN 55303-1891

Mailing address

9125 Quaday Ave NE Ste 102
Otsego, MN 55330-6662
Phone (763) 274-0373

Other practice location 1

9125 Quaday Ave NE Ste 102
Otsego, MN 55330-6662
Phone (763) 274-0373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913002896 MN Practitioner - Chiropractic 3870759509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

646 E River Rd
Suite 4
Anoka, MN 55303-1891
Phone (763) 421-1410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6353MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JWLW PLLC CurrentSince Aug 1, 2021 Accepting new patients
Stroh Chiropractic, PLLC Chiropractor PastSince Jun 22, 2021 Accepting new patients

Locations

646 E River Rd
Ste 4
Anoka, MN 55303
Phone (763) 421-1410

Organizations & group practices 2

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": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1184996365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 QUADAY AVE NE STE 102",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306662",
            "telephone_number": "763-274-0373",
            "fax_number": "763-274-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 E RIVER RD STE 4",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031891",
            "telephone_number": "763-421-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9125 Quaday Ave NE Ste 102",
            "address_purpose": "LOCATION",
            "city": "Otsego",
            "state": "MN",
            "postal_code": "553306662",
            "country_code": "US",
            "telephone_number": "763-274-0373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILL",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-02",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.