Randy Joe Willis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3043 Issued in NC

Practice address

607 Rainbow Dr
Kannapolis, NC 28081-4746

Phone

(704) 652-1393

NPI assigned

May 5, 2006

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fidelity Chiropractic, PLLC

  • Chiropractor
  • Kannapolis, NC
  • NPI 1619019858
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1780632422",
    "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"
        },
        {
            "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": {
        "last_name": "WILLIS",
        "first_name": "RANDY",
        "middle_name": "JOE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Woods Whatley, LCSW
• Shvian Whitfield, FNP-C
• Julia Redmon Whitt, FNP
• Amanda Williams
• Olivia Hadley Willis, OTD, OTR/L
• Lilly Randall Wilson, CFNP
• Patricia D. Wilson
• Peyton Nance Wilson, MOT, OTR/L
• Charlotte Windley, LCMHCA
• Wings 2 Fly

• 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.