Willie Kornegay, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH61246406 Issued in WA

Practice address

4916 Center St Ste G
Tacoma, WA 98409-2348

Phone

(253) 912-9653

NPI assigned

Jan 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Willie Kornegay Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1487305595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4916 CENTER ST STE G",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984092348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4916 CENTER ST STE G",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984092348",
            "telephone_number": "253-912-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNEGAY",
        "first_name": "WILLIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61246406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drwillkornegay@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "drwillkornegay@gmail.com",
            "address_1": "4916 Center St Ste G",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984092348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WILLIE",
            "last_name": "KORNEGAY",
            "prefix": "DR.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bridget Francis Kord, MA
• Korean Women'S Association
• Korean Women'S Association
• Korean Women'S Association
• Peter Korin, MSW
• Ihor Korol, PA
• Vera A Korol, MD
• Ekaterina Koroleva, PA-C
• Ernestine Sylvia Koroma, EMT
• Alicia Christel Kors, M.A.

• Chiropractor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Chiropractor in Washington

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