Active NPI
Daniel Wade Willis, D.C.
- Chiropractor
- Atascadero, CA
National Provider Identifier
1568507325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC25112
- Practice address
- 3534 El Camino Real
Atascadero, CA 93422-2532 - Phone
- (805) 462-2595
- Fax
- (805) 462-2595
- NPI assigned
- Feb 20, 2007
- Last updated
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC25112 | CA | Primary |
Addresses
Primary practice location
3534 El Camino Real
Atascadero, CA 93422-2532
Mailing address
5600 Arroyo Ave
Atascadero, CA 93422
Phone (806) 466-7240
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC25112 | CA | MD | Chiropractor |
| 25112 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1568507325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5600 ARROYO AVE",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "93422",
"telephone_number": "806-466-7240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3534 EL CAMINO REAL",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934222532",
"telephone_number": "805-462-2595",
"fax_number": "805-462-2595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "DANIEL",
"middle_name": "WADE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC25112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atascadero, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.