Active NPI
Lecraig John Willemstein, D.C.
- Chiropractor
- Tulsa, OK
National Provider Identifier
1215027255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2393
- Practice address
- 2303 S Memorial Dr
Tulsa, OK 74129-2615 - Phone
- (918) 622-9533
- Fax
- (918) 622-9536
- NPI assigned
- Oct 13, 2006
- Last updated
- Oct 31, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2393 | OK | Primary |
| Chiropractor | 111N00000X | 4540 | TX |
Addresses
Primary practice location
2303 S Memorial Dr
Tulsa, OK 74129-2615
Mailing address
2303 S Memorial Dr
Tulsa, OK 74129-2615
Phone (918) 622-9533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4540 | TX | MD | Chiropractor |
| 2393 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willemstein Enterprises, Inc | Chiropractor | Current | Accepting new patients |
Locations
2303 S Memorial Dr
Tulsa, OK 74129
Phone (918) 622-9533
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1215027255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2303 S MEMORIAL DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741292615",
"telephone_number": "918-622-9533",
"fax_number": "918-622-9536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2303 S MEMORIAL DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741292615",
"telephone_number": "918-622-9533",
"fax_number": "918-622-9536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEMSTEIN",
"first_name": "LECRAIG",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "2393",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "4540",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.