Organization Active NPI

Levy-Peart Chiropractic Corporation

Doing business as Willits Chiropractic Clinic

  • Chiropractor
  • Willits, CA
National Provider Identifier
1679780647
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0157610 Issued in CA
Legal business name
LEVY-PEART CHIROPRACTIC CORPORATION
Doing business as
Willits Chiropractic Clinic
Practice address
1225 S Main St
Willits, CA 95490-4305
Phone
(707) 459-4689
Fax
(707) 459-9484
NPI assigned
May 17, 2007
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. Diana Elise Levy-Peart, DCNPI 1174684492
Title
Owner Chiropractor
Phone
(707) 459-4689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC0157610 CA Primary

Addresses

Primary practice location

1225 S Main St
Willits, CA 95490-4305

Mailing address

1225 S Main St
Willits, CA 95490-4305
Phone (707) 459-4689

Other identifiers 1

IdentifierTypeStateIssuer
1174684492OtherCANPI TYPE 1

Other names 1

  • Willits Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050228000878 CA Part B Supplier - Clinic/Group Practice 2769435957 Receives reassigned benefits from 1 practitioner
Practice locations: Willits, CA

National Provider Directory

National Provider Directory

Locations

1225 S Main St
Willits, CA 95490
Phone (707) 459-4689

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1679780647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904305",
            "telephone_number": "707-459-4689",
            "fax_number": "707-459-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904305",
            "telephone_number": "707-459-4689",
            "fax_number": "707-459-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVY-PEART CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "LEVY-PEART",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "707-459-4689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0157610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1174684492",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willits Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willits, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.