Active NPI
Douglas L. Willemin, D.C.
- Chiropractor
- Sheridan, MI
National Provider Identifier
1700969284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301004754
- Practice address
- 500 S Main St
Ste 2
Sheridan, MI 48884-9775 - Phone
- (989) 291-3202
- Fax
- (989) 291-3203
- NPI assigned
- Oct 20, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301004754 | MI | Primary |
| Chiropractor | 111N00000X | CHIR002580 | GA |
Addresses
Primary practice location
500 S Main St
Ste 2
Sheridan, MI 48884-9775
Mailing address
PO Box 338
Sheridan, MI 48884-0338
Phone (989) 291-3202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2123215 | Medicaid | MI |
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 |
|---|---|---|---|
| CHIR002580 | GA | MD | Chiropractor |
| 2301004754 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1700969284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 338",
"city": "SHERIDAN",
"state": "MI",
"postal_code": "488840338",
"telephone_number": "989-291-3202",
"fax_number": "989-291-3203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MAIN ST",
"address_2": "STE 2",
"city": "SHERIDAN",
"state": "MI",
"postal_code": "488849775",
"telephone_number": "989-291-3202",
"fax_number": "989-291-3203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEMIN",
"first_name": "DOUGLAS",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301004754",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR002580",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2123215",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.