Individual provider Active NPI

Doug S Willems, D.C.

  • Chiropractor
  • Bend, OR
National Provider Identifier
1669486221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 2928 Issued in OR
Practice address
2041 NE Williamson CT Ste a
Bend, OR 97701-3941
Phone
(541) 389-7660
Fax
(541) 389-9204
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 2928 OR Primary

Addresses

Primary practice location

2041 NE Williamson CT Ste a
Bend, OR 97701-3941

Mailing address

2041 NE Williamson CT Ste a
Bend, OR 97701-3941
Phone (541) 389-7660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000144 OR Practitioner - Chiropractic 1254334436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

242 SW 4TH St
Madras, OR 97741-1364

242 SW 4TH St a
Madras, OR 97741-1364
Phone (541) 475-6427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27 2928ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Doug Willems D.C., P.C. Chiropractor CurrentSince Sep 10, 2013 Accepting new patients
Satori Enterprises LLC Chiropractor Past Accepting new patients

Locations

2041 NE Williamson Ct
Ste A
Bend, OR 97701
Phone (541) 389-7660

612 NE Savannah Dr
Ste 1
Bend, OR 97701
Phone (541) 385-7890

242 SW 4th St
Ste A
Madras, OR 97741
Phone (541) 389-7660

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669486221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 NE WILLIAMSON CT STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013941",
            "telephone_number": "541-389-7660",
            "fax_number": "541-389-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 NE WILLIAMSON CT STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013941",
            "telephone_number": "541-389-7660",
            "fax_number": "541-389-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEMS",
        "first_name": "DOUG",
        "middle_name": "S",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 2928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.