Organization Active NPI

Willis Chiropractic LLC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1427985605
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILLIS CHIROPRACTIC LLC
Practice address
8641 Watson Rd
Saint Louis, MO 63119-5109
Phone
(314) 962-3130
Fax
(314) 962-7233
NPI assigned
May 4, 2026
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Dr. Dameon Lee Willis, DCNPI 1942137179
Title
Doctor
Phone
(314) 586-5434

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

8641 Watson Rd
Saint Louis, MO 63119-5109

Mailing address

8641 Watson Rd
Saint Louis, MO 63119-5109
Phone (314) 962-3130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260520001226 MO Part B Supplier - Clinic/Group Practice 7113496068 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

8641 Watson Rd
Saint Louis, MO 63119
Phone (314) 918-8090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1427985605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8641 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195109",
            "telephone_number": "314-962-3130",
            "fax_number": "314-962-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195109",
            "telephone_number": "314-962-3130",
            "fax_number": "314-962-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "DAMEON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "314-586-5434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.