Devan Williams

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6217 Issued in OR

Practice address

9975 SW Frewing St Ste 210
Tigard, OR 97223-5092

Phone

(503) 444-1953

NPI assigned

Apr 11, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Accident Care Chiropractic and Massage of Tigard

  • Chiropractor
  • Tigard, OR
  • NPI 1447600341
  NPD (past)
• Active Acupuncture Chiropractic and Massage LLC

  • Chiropractor
  • Portland, OR
  • NPI 1518454727
  NPD (past)

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1285376152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9975 SW FREWING ST STE 210",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235092",
            "telephone_number": "503-444-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 SW FREWING ST STE 210",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235092",
            "telephone_number": "503-444-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "6217",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "6217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce Rustin Willcox, DMD, MS
• Amanda Williams
• Brianna Williams
• Chantia Shyannne Williams
• Cornelius Vann Williams
• Eric Daryl Williams
• Gregory A Williams, D.M.D., PC
• Kahloy Hugh Williams
• Kessa Williams, MA, QMHP
• Kimberly Sue Williams, FNP

• All providers in Tigard, OR
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.