Individual provider Active NPI

Martin Anthony Willmitch, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1467513820
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH-7751 Issued in FL
Practice address
2901 West Busch Blvd.
#910
Tampa, FL 33618
Phone
(813) 933-6481
Fax
(813) 932-2229
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-7751 FL Primary

Addresses

Primary practice location

2901 West Busch Blvd.
#910
Tampa, FL 33618

Mailing address

2901 West Busch Blvd.
#910
Tampa, FL 33618
Phone (813) 933-6481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027000637 FL Practitioner - Chiropractic 0244292811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH-7751FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Injury Physicians of Town & Country Inc CurrentSince Sep 13, 2024 Accepting new patients

Locations

5411 Beaumont Center Blvd
Ste 785
Tampa, FL 33634
Phone (813) 709-7185

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1467513820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 WEST BUSCH BLVD.",
            "address_2": "#910",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-933-6481",
            "fax_number": "813-932-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 WEST BUSCH BLVD.",
            "address_2": "#910",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-933-6481",
            "fax_number": "813-932-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMITCH",
        "first_name": "MARTIN",
        "middle_name": "ANTHONY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-7751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.