Individual provider Active NPI

Paul Andrew Willmon, D.C.

  • Chiropractor
  • Cypress, TX
National Provider Identifier
1467450460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8272 Issued in TX
Practice address
15202 Mason Rd
Suite 800
Cypress, TX 77433-9911
Phone
(281) 256-8100
Fax
(281) 256-8163
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8272 TX Primary

Addresses

Primary practice location

15202 Mason Rd
Suite 800
Cypress, TX 77433-9911

Mailing address

15202 Mason Rd
Suite 800
Cypress, TX 77433-9911
Phone (281) 256-8100

Other identifiers 1

IdentifierTypeStateIssuer
20-5670504OtherTXTAX IDENTIFICATION NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050521000031 TX Practitioner - Chiropractic 6709827546 Receives reassigned benefits from 1 practitioner
Practice locations: Cypress, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16341 Mueschke Rd
Suite 200
Cypress, TX 77433-2147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8272TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Chiropractic Chiropractor CurrentSince Oct 13, 2006 Accepting new patients
Empdc, Inc Chiropractor Past Accepting new patients
Rose Family Chiropractic Wellness Center LLC Chiropractor PastSince Jun 16, 2014 Accepting new patients

Locations

15202 Mason Rd
Ste 800
Cypress, TX 77433
Phone (281) 256-8100

16341 Mueschke Rd
Ste 200
Cypress, TX 77433
Phone (281) 256-8100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467450460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15202 MASON RD",
            "address_2": "SUITE 800",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774339911",
            "telephone_number": "281-256-8100",
            "fax_number": "281-256-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15202 MASON RD",
            "address_2": "SUITE 800",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774339911",
            "telephone_number": "281-256-8100",
            "fax_number": "281-256-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMON",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "20-5670504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.