NPIMap

Organization Active NPI

Mission Chiropractic LLC

  • Chiropractor
  • Mission, KS
National Provider Identifier
1306909114
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MISSION CHIROPRACTIC LLC
Practice address
6556 Johnson Dr
Mission, KS 66202-2615
Phone
(913) 432-4780
Fax
(913) 262-2690
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Dr. Brad S Willits, D. C.NPI 1154318921
Title
Sole Member
Phone
(913) 432-4780

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

6556 Johnson Dr
Mission, KS 66202-2615

Mailing address

6556 Johnson Dr
Mission, KS 66202-2615
Phone (913) 432-4780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070205000489 KS Part B Supplier - Clinic/Group Practice 8921000969 Receives reassigned benefits from 2 practitioners
Practice locations: Mission, KS

National Provider Directory

National Provider Directory

Locations

6556 Johnson Dr
Mission, KS 66202
Phone (913) 432-4780

Practitioners & affiliated clinicians

Practitioners 10

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1306909114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6556 JOHNSON DR",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022615",
            "telephone_number": "913-432-4780",
            "fax_number": "913-262-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6556 JOHNSON DR",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022615",
            "telephone_number": "913-432-4780",
            "fax_number": "913-262-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "WILLITS",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "913-432-4780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.