Individual provider Active NPI

Michael Willis, D.C.

  • Chiropractor
  • Westlake Village, CA
National Provider Identifier
1598835910
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20037 Issued in CA
Practice address
910 Hampshire Rd Ste U
Westlake Village, CA 91361-2896
Phone
(805) 527-4767
Fax
(858) 901-1346
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20037 CA Primary

Addresses

Primary practice location

910 Hampshire Rd Ste U
Westlake Village, CA 91361-2896

Mailing address

PO Box 1176
Cardiff, CA 92007-7176
Phone (760) 436-7999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091231000268 CA Practitioner - Chiropractic 3274507207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

910 Hampshire Rd
Suite U
Westlake Village, CA 91361-2896
Phone (805) 527-4767

910 Hampshire Rd U
Westlake Village, CA 91361-2896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC20037CAMDChiropractor
20037CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MLW,Inc Chiropractor CurrentSince Nov 27, 2017 Accepting new patients
Chiropractic 4 All Chiropractor Past Accepting new patients

Locations

40 W Cochran St
Ste 104
Simi Valley, CA 93065
Phone (805) 527-4767

910 Hampshire Rd
Ste U
Westlake Village, CA 91361
Phone (805) 527-4767

Organizations & group practices 2

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1598835910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1176",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920077176",
            "telephone_number": "760-436-7999",
            "fax_number": "760-436-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HAMPSHIRE RD STE U",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612896",
            "telephone_number": "805-527-4767",
            "fax_number": "858-901-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.