Fidelity Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FIDELITY CHIROPRACTIC, PLLC

Practice address

607 Rainbow Dr
Kannapolis, NC 28081-4746

Phone

(704) 652-1393

NPI assigned

Feb 13, 2007

Last updated

Mar 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randy Joe Willis, D.C.NPI 1780632422

Title

Manager

Phone

(704) 652-1393

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randy Joe Willis, D.C.

  • Chiropractor
  • Kannapolis, NC
  • NPI 1780632422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1619019858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 OAK AVE STE 155",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814329",
            "telephone_number": "980-330-1680",
            "fax_number": "704-782-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 RAINBOW DR",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814746",
            "telephone_number": "704-652-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELITY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-652-1393",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Kannapolis, NC
• Providers in Kannapolis, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.